In general, individuals who cannot absorb vitamin B12 correctly may have pernicious anemia
The Pernicious Anaemia Society notes this is recognised but not fully understood

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Unlike growth hormone secretagogues that act on a single receptor family, BPC-157s proposed mechanisms appear to touch multiple physiological systems, which is part of why it has drawn broad interest across several research domains, including tissue repair, angiogenesis, and gut-brain axis studies