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Giannoulis MG, Sonksen PH, Umpleby M, et al

This peptide promotes healthy tissue remodeling and reduces excessive scar tissue formation through its effects on actin regulation and cell migration

[124] Other causes of B 12 malabsorption include bariatric surgery, pancreatic insufficiency, obstructive jaundice, tropical sprue, celiac disease, inherited intrinsic factor deficiency, and radiation enteritis affecting the distal ileum

That means three things in practice

The most effective prevention strategy combines adequate protein intake (1.0-1.2 grams per kilogram daily), comprehensive micronutrient supplementation from day one, gradual dose titration to moderate the rate of weight loss, maintaining a caloric floor, and baseline blood work to identify and correct pre-existing deficiencies