Conditions such as intestinal or stomach problems, poor nutrition, HIV, pregnancy, old age, veganism and alcoholism can contribute to vitamin B12 deficiency
Neurologic complications are not always associated with megaloblastic anemia and are the only clinical symptom of vitamin B 12 deficiency in about 25% of cases (21)
Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey
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Individuals on other medications should discuss peptide use with healthcare providers
