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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

The duration varies between patients

Lambert-Eaton myasthenic syndrome: ocular signs and symptoms

In mice with high-fat diet-induced hyperglycemia, hyperinsulinemia, and associated induction of TNF, a reduction of GLP-1-secretion was observed, which could be reversed by treatment with the TNF-neutralizing antibody etanercept (95)

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