Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history
These findings have spurred countless research projects using BPC-157 in models of tendinopathy and ligamentous injury
Giving them more frequently than the established schedule is a form of over-treatment that is not supported by evidence and can strain healthcare resources (nurses time, clinic space, and medication supplies)
[1] In rare cases, patients may develop subcutaneous nodules due to local tissue reactions or improper injection technique, such as injecting too superficially or too deeply
