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Therefore, those who are vegetarian or vegan are more likely to be deficient in vitamin B12
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
If spray achieves even 20 to 40 percent of the absorbed dose of injection (a rough analogy from other peptide nasal delivery literature, not a BPC 157-specific number), the effective dose delivered may be far below what rodent studies used
High doses of either form may cause liver dysfunction with long-term use
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