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According to the NIH Office of Dietary Supplements, functional B12 deficiency is most commonly seen in patients with one or more of the following: Age over 50 stomach acid production declines with age, and stomach acid is required to free B12 from food PPI or H2 blocker use reflux medications suppress the acid needed for B12 absorption Metformin use, which interferes with B12 absorption directly Vegan or vegetarian diets B12 is found almost exclusively in animal products Gut conditions including celiac, IBS, SIBO, and Crohns MTHFR mutations that affect how B12 is metabolized once absorbed Heavy alcohol use The symptoms of low B12 are easy to dismiss: fatigue, brain fog, low mood, tingling in the hands or feet, weakness, and shortness of breath on mild exertion
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Dosage Range (Based on Research): Microgram Range: Common initial research doses range from 100 mcg to 300 mcg daily
Gastrointestinal and tendon/ligament research: BPC-157 has the most consistent preclinical signal here, including reported reductions in gastric ulcer surface area and accelerated tendon healing in rodent models
This is a meaningful finding given how often steroid injections precede the chronic tendon injuries patients bring to us
People who are leaner sometimes struggle with abdominal injections because the fat layer there can be thin, increasing the risk of accidental intramuscular injection
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