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Following a strict vegetarian or vegan diet without ingesting any animal products, having a poor diet while pregnant, or being fed a poor diet as an infant can all lead to vitamin B12 deficiency

BPC-157 has the most direct evidence for knee pain

Conclusion B12 injections offer a scientifically proven solution for addressing widespread deficiency issues that compromise energy, cognitive function, and overall wellness in our modern environment

Cleveland Clinic

If you want a deeper understanding of how this peptide fragment interacts with growth hormone pathways, the IGF-1 LR3 guide provides helpful context on growth hormone signaling

A nasal spray is also available but is not considered the best treatment for severe deficiency because B12 is not absorbed as well as it is via injection