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The B12 is bound to the protein molecules

Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release

The break helps prevent receptor desensitization

AOD-9604 is currently sold for research purposes only and lacks regulatory approval from any major health authority worldwide

Why it fails for multi-dose peptide vials: Once the seal is punctured, there's no preservative inhibiting bacterial growth