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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

The equipment, while regulated, differs from pharmaceutical manufacturing lines

But if the stall coincides with using medication from an older vial or one with questionable storage history, degradation should be on your list of suspects

BPC-157 is not a replacement for surgery in cases of complete tears or structural failure