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For each eligible study, two authors (MM and AN) independently extracted data, which was then reviewed by a third author (JV) using a piloted spreadsheet, in accordance with Cochrane Collaboration guidelines ( Where relevant data were missing, attempts were made to contact corresponding authors

Sermorelin is a synthetic peptide that mimics the action of growth hormone-releasing hormone (GHRH), a naturally occurring hormone produced by the hypothalamus

These symptoms develop gradually because the body stores several years worth of B12 in the liver, meaning deficiency takes time to become clinically apparent

Adults generally require around 1.5 micrograms per day and pregnant or breastfeeding women require up to 2.8 micrograms a day