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Follow-Up and Monitoring We schedule follow-up appointments to track your body composition changes, assess progress, and adjust your protocol as needed

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria

Other at-risk patients include the elderly, people with digestive tract problems, and people taking certain long-term medications for heartburn or diabetes