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CJC-1295/Ipamorelin is not FDA approved as a combination product, and neither individual peptide has FDA approval for human therapeutic use

[DOI] [PubMed] [Google Scholar] 75.Pollack A

Treatment with pramipexole and ropinirole (in combination with levodopa-carbidopa) for 14 days significantly reduced small intestinal motility, increased bacterial overgrowth in the distal small intestine, increased bacterial richness in the jejunum (not the ileum), and had a significant effect on -diversity in both proximal small intestine and ileum, with Muribaculaceae and Lactobacillus mostly contributing to the variation [73]

& Lindholm, D

It seems there may be a general lack of education available to most doctors about the different forms of B12 and what those forms are as well as how they get converted within the body and what each is most beneficial for (not to mention which set of genes or genetic mutations could benefit most from which B12 type)