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Groups at higher risk of deficiency include older adults (due to reduced stomach acid production), vegans and vegetarians, people with pernicious anaemia or gastrointestinal disorders affecting absorption, and those taking certain medications such as metformin or proton pump inhibitors

Sermorelin was previously FDA-approved (Geref, discontinued 2008) and as of June 2026 remains legally compoundable through 503A and 503B pharmacies with a valid prescription

Sterile water has no preservative and is intended for single-use only

GLP-1 therapy contributes the gastrointestinal side effects characteristic of the class: nausea (particularly during dose escalation), occasional vomiting, constipation, and reduced appetite that is the desired effect but can be excessive in some patients

Novel methylcobalamin nasal spray versus intramuscular injection: A randomized, crossover comparative bioavailability study Int J Endocrinol Metab Disord

This method is particularly effective for people with vitamin B12 deficiency, which is common in older adults, vegetarians, and individuals with certain medical conditions