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People with gastrointestinal issues that affect B-12 absorption, like Crohns disease or celiac disease, pernicious anemia, a history of stomach or bariatric surgery, or heavy alcohol use, may also be at risk for low B-12 levels

However, TRT therapy is not for everyone

The initial energy boost can be felt within hours or days and may last for a week or so

No human safety data : The complete absence of human clinical trials means the safety profile, side effects, optimal dosing, and pharmacokinetics in humans are entirely unknown Animal-to-human translation is uncertain : Metabolic differences between mice and humans mean that the magnitude of effects (e.g., weight loss, grip strength improvement) may not translate