A 2018 review described BPC-157 in relation to standard angiogenic growth factors, discussing tendon, ligament and bone healing models and angiogenic effects

Contact your GP or healthcare provider if you experience: Severe or worsening joint pain that interferes with daily activities or does not improve with simple measures Joint swelling, redness, or warmth , which may indicate inflammation or infection Sudden onset of intense pain in a single joint, particularly if accompanied by fever (may require same-day assessment to exclude septic arthritis or gout) Joint pain associated with systemic symptoms such as unexplained fever, weight loss (beyond expected treatment effects), rash, or general malaise Persistent pain lasting more than two weeks despite self-care measures Joint stiffness lasting more than 30 minutes after waking , which may suggest inflammatory arthritis Reduced range of motion or inability to bear weight on affected joints Seek urgent medical attention (contact 111 or attend A&E) if: Joint pain is accompanied by severe abdominal pain, persistent vomiting, or signs of pancreatitis (if pancreatitis is suspected, stop your GLP-1 medication immediately

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So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets
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