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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

Int J Biochem Cell Biol (2008) 40(10):19849.10.1016/j.biocel.2007.07.008 9 WatersMJBrooksAJ

Can I use GHK-Cu with minoxidil and finasteride

Toxicol Appl Pharmacol 15(435):115853 Moore EM, Mander AG, Ames D et al (2013a) AIBL Investigators Increased risk of cognitive impairment in patients with diabetes is associated with metformin

Patients who are breastfeeding or planning to breastfeed should inform their healthcare provider