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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 [6] [8] 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
Treatment of 24-month-old mice (equivalent to elderly humans) with NNMT inhibitors rescued age-related deficits in muscle stem cell activity
Anti-inflammatories, including vitamin C can interact with B12 injections
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Comparison with thymosin peptides TB-500 , a synthetic fragment of thymosin beta-4, promotes tissue repair through different mechanisms than copper peptides
However, stomach acid and the enzyme pepsin are absolutely essential for cleaving Vitamin B12 from dietary proteins
