You may also be more likely to develop vitamin B-12 deficiency if you have: Atrophic gastritis, in which your stomach lining has thinned Pernicious anaemia, which makes it hard for your body to absorb vitamin B12 Conditions that affect your small intestine, such as Crohns disease, celiac disease, bacterial growth, or a parasite Immune system disorders, such as Graves disease or lupus Been taking certain medications that interfere with the absorption of B12
Giving them more frequently than the established schedule is a form of over-treatment that is not supported by evidence and can strain healthcare resources (nurses time, clinic space, and medication supplies)
Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history
It should not never be given to neonates or infants , because benzyl alcohol can cause serious toxicity (the gasping syndrome in preterm babies)
These findings have spurred countless research projects using BPC-157 in models of tendinopathy and ligamentous injury
