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Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey

HGF/c-Met signaling is a well-established oncogenic pathway: c-Met is amplified or overexpressed in multiple cancers (gastric, lung, renal, hepatocellular) HGF/c-Met activation promotes tumor cell proliferation, survival, invasion, and metastasis c-Met inhibitors are FDA-approved cancer drugs (cabozantinib, crizotinib, capmatinib) A compound that potentiates HGF/c-Met signaling raises theoretical concerns about promoting tumor growth or transformation with chronic use

Clinical and Translational Medicine, 14 (3), Article e1636

This enzyme converts homocysteine (a potentially harmful amino acid) into methionine