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Other groups who may benefit include: Patients following gastric surgery (gastrectomy, bariatric procedures) where intrinsic factor production or absorption sites are compromised Individuals with malabsorption disorders such as Crohn's disease, coeliac disease, or chronic pancreatitis Strict vegans and vegetarians with dietary insufficiency, though oral supplementation is usually tried first Elderly patients with atrophic gastritis or reduced gastric acid production Patients on long-term metformin or proton pump inhibitors, which can impair B12 absorption Individuals with nitrous oxide exposure (recreational or medical), which can cause functional B12 deficiency Diagnosis typically involves serum B12 measurement, with levels below approximately 148 pmol/L (though thresholds vary between laboratories) generally indicating deficiency

The GHK-Cu injection dosage guide explains why this has become the standard reference point

Many patients find it helpful to avoid certain triggers such as sun exposure, certain foods, or alcohol, and to follow an effective skin care regimen including sunblock, gentle cleansing, and moisturizing

This makes them especially helpful for people with sensitive stomachs or those already taking multiple medications

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