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[124] Other causes of B 12 malabsorption include bariatric surgery, pancreatic insufficiency, obstructive jaundice, tropical sprue, celiac disease, inherited intrinsic factor deficiency, and radiation enteritis affecting the distal ileum

Those are policy questions, not simply scientific ones

But in 2023, the Food and Drug Administration rightly moved peptides to a no-compounding-allowed status called Category 2 due to concerns about safety and lack of clinical trial data

A practical framework for counseling patients I do not think there is a single right stance

The Nutrition Source

Several factors throw this cycle off balance