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Patients with pernicious anaemia, malabsorption disorders (such as Crohn's disease or coeliac disease), or following gastric surgery require regular B12 supplementation to prevent serious complications including megaloblastic anaemia and neurological damage
Distributed under the brand names Geref and Geref Diagnostic, it gained FDA approval in 1997 as a treatment for growth hormone deficiency but was discontinued in 2008 not out of concern for safety or lack of efficacy, but because of manufacturing difficulties.2 3 Yet it remains available in compounded form with a prescription from a licensed healthcare provider
It effectively paralyzes or weakens the targeted muscle
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