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Some types of synthetic peptides also known as growth hormone secretagogues (GHS) may reduce the bodys sensitivity to insulin and may increase the blood sugar

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Stancliffe RA, Thorpe T, Zemel MB

While there are many reasons why someone could feel fatigued, B12 is a part of the picture and correcting the deficiency can greatly improve energy levels

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Int J Biodivers Sci Manag 3(4):234251 Sandblom G, Videhult P, Karlson B-M, Wollert S, Ljungdahl M, Darkahi B, Liljeholm H, Rasmussen IC (2009) Validation of gastrointestinal quality of life index in swedish for assessing the impact of gallstones on health-related quality of life