do vitamin b12 injections cause constipation in deficiency is primarily neurogenic, due to autonomic and enteric neuropathy causing slow gut motility • Constipation may precede anemia • Often improves after B12 replacement • Think of B12 Can Vitamin B12 Deficiency Indicate

Case 4 A 33-year-old male, presented with complaints of difficulty in performing fine movements with both hands since last 10 days without having any complaints in lower limbs

The CKD code is sequenced first, then D63.1

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Specifically, it produces no IGF-1 elevation (avoiding proliferative concerns), no negative impact on glucose metabolism (avoiding diabetes risk), no fluid retention or edema, and no concerning patterns of joint pain that can occur with growth hormone

Comfort with Injections Are you comfortable with self-injecting, or would you prefer a non-invasive treatment