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The strongest predictors are baseline IGF-1 level, age, sleep quality (7-9 hours nightly), training consistency (4-6 days/week), diet quality, and protocol adherence

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Study design: hormone-manipulation protocol Throughout the six-month protocol, each participant received monthly injections of the GnRH agonist depot leuprolide acetate (Lupron, 3.75 mg IM), which suppresses the ovarian secretion of estradiol and progesterone

Also, certain medications, like proton pump inhibitors and metformin, might affect B12 absorption

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Exact same thing for me as well