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Effects of GLP-1 Agonists on Proportion of Weight Loss in Obesity With or Without Diabetes: Systematic Review and Meta-Analysis
4,5 Dietary insufficiency, pernicious anemia (i.e., an autoimmune process that reduces available intrinsic factor and subsequent absorption of vitamin B 12 1,2,6,7 ), and long-term use of metformin or acid-suppressing medications have been implicated in B 12 deficiency
Similar concerns apply to phosphodiesterase-5 inhibitors (medications like sildenafil) and L-arginine supplements that also influence nitric oxide signaling
Key areas include establishing doseresponse relationships, defining optimal timing for intervention, and identifying biomarkers (e.g., AIFM1 levels, respiratory chain function, neuroimaging) to predict responder status
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