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Common causes include pernicious anaemia (autoimmune condition), plant-based diets without supplementation, gastrointestinal surgery, and long-term use of metformin or proton pump inhibitors

For gastrointestinal conditions specifically, some clinicians use oral capsules, since the peptide acts directly on the gut lining

References For Further Reading (1) A M Reznichenko, V P Fesenko, D V Shestopalov, and P A Tatarchuk (2001) Changes in cell immunity indexes under the influence of thymalin, thyroxine and fibronectin in patients with hyperplastic diseases of thyroid gland before and after the surgery Klin Khir, 2001 Dec: (12): Pages 31-3

Its frequently chosen when the goal isnt just weight loss, but improving how the body uses fuelsupporting energy production and metabolic efficiency

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However, post-reconstitution solutions require specialized temperature controls