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The patient has addressed the foundation: protein intake adequate, strength training in place, tracking honest

Most discussion about combined use is based on: extrapolations from independent studies theoretical complementarity of mechanisms observations in research-community settings Because controlled combination studies are rare, proposed interactions remain speculative

however, it is not FDA-approved for humans, and the World Anti-Doping Agency has banned its use due to its benefits potentially enhancing athlete performance

Additionally, vitamin B 12 deficiency can also occur as a result of other malabsorptive conditions (such as inflammatory bowel disease, or pancreatic insufficiency), after certain procedures (such as bariatric surgery, or ileal resection), restricted diets (such as veganism), or the use of certain medications (such as metformin or proton-pump inhibitors)