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Who to refer: Patients: with symptoms suggestive of either a spinal cord lesion (subacute combined degeneration or peripheral neuropathy) or visual (optic neuropathy) same day emergency admission not responding haematologically to B12 replacement therapy (where folate and iron stores have been checked and are normal) with suspected malabsorption or disease of the terminal ileum should be referred to Gastroenterology with neurological symptoms should be discussed with Neurology if advice required

Understanding what each peptide is and where it comes from provides essential context for appreciating how they might support recovery

Current Patients: Red Flags That Warrant Action If you are already enrolled, certain signals should prompt an immediate clinical conversation or a transition to another provider

A patient with a serious non-healing musculoskeletal injury, conventional options exhausted, full informed consent, ideally inside a registered investigational protocol with structured safety monitoring