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This suppresses production of pro-inflammatory cytokines including TNF-alpha, IL-1beta, and IL-6 (the same IL-6 that paradoxically stimulates GLP-1 production in a feedback loop)

Treatment for confirmed B12 deficiency includes oral cyanocobalamin for dietary causes or intramuscular hydroxocobalamin for malabsorption or neurological involvement, following NHS and BNF guidance

The dose escalation schedules used when initiating these medications are carefully designed to allow your body to adapt gradually, minimising side effects whilst achieving therapeutic levels

This is why most diet-only approaches see weight regain beginning within the first year, while GLP-1 medications extend the active loss phase to 18 to 24 months or longer

Acta 1760 (7), 10641070