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One consideration specific to peptide stability deserves mention

People who have difficulty processing vitamin B12 may develop anemia

Approach Loading Per-session dose 500-1,000 mg Schedule 3-5 consecutive days, then weekly/monthly Notes Clinic-supervised only

Further considerations include: Dehydration risk : Combined effects of diarrhoea (from both Crohn's and medication) may increase dehydration risk Medication absorption : While generally minimal, delayed gastric emptying could affect absorption of oral medications with a narrow therapeutic index Monitoring requirements : Regular assessment of disease activity markers, nutritional status, and weight trends is essential Patients should be counselled about these risks and encouraged to report any worsening gastrointestinal symptoms promptly to the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk), as distinguishing between expected side effects and disease progression requires clinical expertise