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Deficiencies of such vitamins, however, may be a presenting feature in alcohol use disorder, malnourishment, or malabsorption syndromes such as short-bowel syndrome due to the removal of the small bowelthe site of absorption of all vitamins

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10.1093/aje/kwy081 9 American Medical Association (1992)

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Perturbations in microbial composition can arise from dietary imbalances, excessive pharmacotherapy, alcohol consumption, smoking, and chronic stress, leading to the depletion of beneficial bacteria and overgrowth of pathogenic species (69), thereby disrupting immune homeostasis