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Other factors which can cause Pernicious Anemia and/or low B12 besides hypothyroidism Pancreatic insufficiency (when the pancreas is making le ss digestive enzymes) Gastritis (bacterial-caused inflammation which weakens the stomach lining) Stomach Removal (whether partial from Bariatric Surgery, or complete removal) Stomach cancer Active mutation of the Q5R intrinsic factor gene, plus other genes Low levels of folate aka B9 Symptoms of Pernicious Anemia From : The symptoms of pernicious anemia may include weakness, fatigue, an upset stomach, an abnormally rapid heartbeat (tachycardia), and/or chest pains

Bethesda, MD: National Cancer Institute

For instance, enhanced angiogenesis might favor ovarian recovery yet could complicate hormone-dependent growths

Melasma : This is a complex and stubborn type of pigmentation that is a result of hormonal dysregulation and sun exposure

Before deciding to get these injections, it's essential to have realistic expectations