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While the body stores a certain amount of B12, long-term deficiency can develop gradually, particularly in individuals with restricted dietssuch as vegansor those with medical conditions that impair absorption, such as pernicious anaemia or gastrointestinal disorders like coeliac disease or Crohns disease

It bypasses the normal feedback loops that regulate IGF-1 production, including GH negative feedback on the pituitary

doi: 10.3390/healthcare9101290 25 WongTLWeitzerDJLongCOVID

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Dual therapy is not appropriate for all patients and is determined on a case-by-case basis by your Rivas provider