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The concomitant use of topiramate with other carbonic anhydrase inhibitors or in patients on a ketogenic diet may create a physiological environment that increases the risk of kidney stone formation and should therefore be avoided

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I wouldnt count on sources like seaweed, spirulina, or soil. I hear people that likely do need to supplement with B12 say that theyre OK because they eat foods that may include B12, but they can be unreliable sources, such as sea vegetables or nutritional yeast, says Ginger Hultin, MS, RDN, CSO, a lifelong vegetarian, chair of the VNDPG, and spokesperson for the Academy

If you take blood thinner medications, talk to your healthcare provider or pharmacist before adding these or other dietary supplements