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Moreover, the administration of these peptides to healthy individuals for anti-aging or performance enhancement introduces additional ethical and safety considerations, as the long-term effects of chronic exposure in otherwise healthy populations remain unknown

[DOI] [PMC free article] [PubMed] [Google Scholar] 197.Biffi A., Montini E., Lorioli L., Cesani M., Fumagalli F., Plati T

A deficiency can lead to a type of anemia that causes pale skin and shortness of breath

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Other indicators include a family history of pernicious anaemia or other autoimmune conditions (such as type 1 diabetes mellitus, Hashimotos thyroiditis, or Graves disease), or if the patient is taking metformin, proton pump inhibitors (PPIs), H2 antagonists or has a history of nitrous oxide misuse[15]