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Digestion Compromised digestion can be an underlying factor, especially of autoimmune thyroid disease such as Hashimotos Thyroiditis, due to the association with increased intestinal permeability (Leaky Gut). 8 This is often mediated by gluten, 9 imbalanced gut bacteria, 10 and stress, 11 which drives autoimmunity, especially if an individual is genetically susceptible. 12 If food is also poorly digested, say from eating on the go, and moves through the gut too fast due to diarrhoea, nutrient absorption becomes harder

That link is part of why gut flares may come with joint aches, skin issues, or tiredness

Interactions with Other Drugs Vitamin B12 can interact with several medications, so inform your healthcare provider about all the drugs you are taking