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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

What this article does is explain why that's genuinely the right answer rather than a brush-off, what is and isn't known about topical copper peptides in this context, and what's worth raising with a doctor rather than guessing at

Weight maintenance after stopping depends on lifestyle habits established during treatment

Alcohol affects B12 absorption in the body in many ways

The peptide did not cause them, but they happened to appear during use

doi: 10.1016/j.redox.2019.101218