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A 2025 systematic review in Orthopaedic Sports Medicine analyzed 36 studies on BPC-157 and found that the peptide improved functional, structural, and biomechanical outcomes in muscle, tendon, ligament, and bone injury models

Medications: Long-term use of acid-reducing drugs (like PPIs) or metformin (for diabetes) can interfere with B12 absorption

This explains why some people need surprisingly high doses despite normal absorption