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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria

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Breastfeeding: Present in breastmilk, use caution

GLP-1 peptides commonly cause: Significant nausea : Often severe enough to require dose titration over months

Replication was undertaken in three cohorts: a Scottish cohort

How Is the Treatment Administered