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Current British Society of Gastroenterology guidance suggests considering a baseline upper GI endoscopy with biopsies in adults aged 50 or over with confirmed pernicious anaemia to document autoimmune gastritis

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Metformin , used in type 2 diabetes management, reduces B12 absorption through unclear mechanisms

Contraindications Given the limited safety data, conservative contraindications would include pregnancy or plans to become pregnant, breastfeeding, age under 18, severe liver or kidney disease, and any condition requiring medications with unknown interaction potential

By enhancing mitochondrial health, SS-31 may support better endurance, strength, and post-workout recovery of muscles

[DOI] [PMC free article] [PubMed] [Google Scholar] Iyamu I