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Diabetes 49 , 12191223 (2000)

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There are various potential causes of vitamin B12 deficiency besides pernicious anemia, which gastrointestinal surgery long-term use of certain medications, such as proton pump inhibitors genetic intrinsic factor defects dietary deficiency Pernicious anemia requires lifelong treatment

Patients with the following characteristics often see the strongest improvements: Rheumatoid arthritis Psoriatic arthritis Osteoarthritis of the knees or hips Obesity or insulin resistance Chronic fatigue Long-term steroid use Difficulty losing weight despite trying Who Should Avoid GLP-1

[8] On concentration: clinical studies generally use 1-3% in optimized delivery systems