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Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

There are concerns about adherence to oral treatment, for example, if the person: Is older, is or has recently been in hospital and has either multimorbidity or frailty

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Stability Comparison Storage Requirements by Type The fragility of first-generation GHK-CU explains why proper storage matters so much for this particular peptide