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The neurological effects of Pernicious Anaemia are complex, and recovery is rarely straightforward

Vitamin B12 Deficiency Causes of vitamin B12 deficiency include difficulty absorbing vitamin B12 from food, lack of intrinsic factor (e.g., because of pernicious anemia), surgery in the gastrointestinal tract, prolonged use of certain medications (e.g., metformin or proton pump inhibitors), and dietary deficiency

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The absence of effects on IGF-1, glucose metabolism, and tissue growth reduces concerns about long-term hormonal consequences, but prudent medical oversight remains appropriate for any extended peptide use

Sadly the NHS very rarely do the correct thyroid testing