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A list of common conditions besides pernicious anemia associated with a B12 deficiency includes the following: Crohns disease Celiac disease Atrophic gastritis, otherwise known as a thinning of the stomach lining Bacteria or parasites in the intestines Immune system disorders, including Graves disease and lupus Inflammatory bowel disease (IBD) Medications Medications can also interfere with B12 absorption, such as some heartburn medicines and proton pump inhibitors prescribed to diabetics

Understanding the difference between research grade and pharmaceutical grade peptides is essential for setting appropriate expectations about purity, potency, and consistency

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doi: 10.1007/s00415-018-9123-1

But of more concern is really that it can cause receptor desensitization, maybe even turn off the whole receptor pathway