Thymosin alpha-1, also known as thymalfasin and marketed as Zadaxin in some countries, works through a mechanism that is genuinely unusual among immune-affecting compounds

The following conditions can cause absorption to be inadequate: Overgrowth of bacteria in part of the small intestine Impaired absorption (malabsorption disorders such as celiac disease or certain pancreatic disorders) Inflammatory bowel disease affecting the last part of the small intestine (IBS) Surgery that removes the part of the small intestine where vitamin B12 is absorbed Drugs such as antacids and metformin (used to treat diabetes) Repeated exposure to nitrous oxide (laughing gas) Lack of intrinsic factor Decreased stomach acidity (common among older people) Intrinsic factor may be lacking because abnormal antibodies, produced by an overactive immune system that attacks and destroys the stomach cells that produce intrinsic factor (An autoimmune reaction called autoimmune metaplastic atrophic gastritis.) Intrinsic factor may be lacking because the part of the stomach where intrinsic factor is produced was surgically removed

This, in turn, as a tremendous impact on everything from cognitive function to wound healing, the immune response, growth hormone secretion, weight gain, bone structure, and cardiovascular health
Duration depends on your goals: postinjury or postsurgery protocols might last 816 weeks, while chronic wearandtear cases may benefit from longer courses with periodic reassessment
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Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease