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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease
Think of it like this: a doctor needs an X-ray to confirm a broken bone before putting on a cast
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So the numbers below come from self-reported community formulations and from the lesser sibling relationship to GHK-Cu, not from clinical dose-finding
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