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Patients may also have low levels of vitamin B12 if they have had bariatric surgery, are strict vegetarians, or have used antacids or proton pump inhibitors for a prolonged period

Maternal Vitamin B12 Status During Pregnancy and Its Association With Outcomes of Pregnancy and Health of the Offspring: A Systematic Review and Implications for Policy in India. Frontiers in Endocrinology vol

Its marketed as a fat-burning peptide that mimics growth hormone without the unwanted side effects

However, oral delivery of the lipotropic components (methionine, inositol, choline) is less predictable