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The literature also describes upregulation of growth factors involved in tissue repair, modulation of nitric oxide synthase activity, and effects on the dopaminergic and serotonergic systems that are harder to interpret clinically [Sikiric et al., Inflammopharmacology, 2018]
A Cochrane review supports the use of high-dose vitamin B 12 (1 mg and 2 mg daily) in elevating serum vitamin B 12 level and achieving haematological and neurological responses, even in patients with PA or with ileal resection.58 The recommendation for oral replacement is 1 mg daily for a month, and then 125 to 250 g daily as maintenance dose for patients with dietary insufficiency and food-cobalamin malabsorption, while for PA the maintenance dose is 1 mg daily.29 Vitamin B 12 does not have side-effects even when prescribed in large doses.59 However, hypokalaemia, resulting from uptake of circulating potassium by newly growing and dividing haematopoietic cells, can be severe or sometimes life-threatening
Concurrent Medications or Supplements : Drugs or supplements that affect digestion, inflammation, or liver metabolism may impact absorption, efficacy, or tolerability of BPC-157
Muller C, et al
Additionally, peptides like SS-31 can also influence growth factors, promoting cellular growth and repair
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