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Long-term acid suppression, particularly with proton pump inhibitor (PPI) therapy, has been associated with potential micronutrient deficiencies, including vitamin B12 and magnesium deficiency, while altered gastric pH may also influence the dissolution and absorption of selected orally administered drugs (78, 84)

Neurotransmitter Metabolites: Markers such as homovanillic acid (HVA) , vanilmandelate (VMA) , and 5-hydroxyindoleacetic acid (5-HIAA) provide clues about dopamine, norepinephrine, and serotonin metabolism

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