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Then the highest dose of oral B12 the NHS would prescribe is 1mg cyancobalamin a day & someone with pernicious anaemia would at best absorb about 1% of that via passive diffusion although it would be interesting to know what effect 100 mg oral B12 would have and I think there is a obvious conflict of interest for GPs to free up nurses than to ask questions like this or properly get feedback from their patents bmj.com/content/365/bmj.l18

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However, insulin can bind both IR and IGF-1R, albeit with a lower affinity for IGF-1R 28

Replacement supports response to prednisolone and dietary therapy