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This complex process means that conditions affecting the stomach or intestines can significantly impair B12 absorption, including pernicious anaemia, atrophic gastritis, previous gastric surgery, coeliac disease, Crohn's disease, and long-term use of certain medications (such as metformin, proton pump inhibitors, and H2 antagonists)
Understanding the legal landscape is also necessary
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If these appear, reduce tirzepatide dose, pause 5-amino-1MQ, and increase caloric intake by 200400 kcal daily until symptoms resolve
If you are looking at B12 injections, the most useful starting point is the NHS treatment pathway, because it is built around how the body uses and stores B12 rather than around how often a top-up feels nice to have
BPC-157 shows particular promise for gastrointestinal healing
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