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Fatigue and weakness are often the first indicators that B12 levels are dropping

10.1039/d2ma00468b 187

The most common types of cancers that cause B12 deficiency are mentioned below: Gastrointestinal Cancers The prevalence of gastrointestinal (GI) tract cancers, such as cancer of the small intestine, pancreas, or colon, is often higher in individuals with Vitamin B12 deficiency

For keeping up the treatment, injections are often given monthly

A particular relationship was established with the NO-system, and the advantage of the BPC 157 over the corresponding standard agents (i.e., corticosteroids, sulfasalazine, H2 blockers, anticholinergics, and proton pump inhibitors) which showed only weak, if any, effect on these fistulas closing (Skorjanec et al., 2009