This appears to be a transient effect related to the healing process rather than a worsening of the condition
quiz 106 Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Lindenbaum J: Effective treatment of cobalamin deficiency with oral cobalamin
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Treatment: Inj abdomen 1x daily
For individuals with Wilson's disease (a genetic disorder causing copper accumulation) or other copper metabolism disorders, theoretical caution is warranted, though even in these populations topical GHK-Cu is unlikely to pose significant risk given the minimal systemic absorption
Based on the updates to the burden calculations in response to commenters, we now estimate the cost per response to be $5,047.15 and the total estimated cost across all survey respondents to be $22,712,175