MTHFR variants can reduce methylfolate production, which affects the methylation cycle and SAMe availability
Importantly, serum B12 levels can be misleadingly normal or even elevated in chronic liver disease due to increased levels of binding proteins (such as haptocorrin) and reduced clearance, meaning that total B12 measurements may not accurately reflect tissue B12 status or functional deficiency
I have had patients do better on semaglutide than tirzepatide because the side effects were more manageable for them, despite the trial data favoring tirzepatide
Rybelsus : Occasionally covered for diabetes, but rarely for weight loss
Injectable options with established authorisation: Semaglutide 2.4 mg (Wegovy) : A once-weekly GLP-1 receptor agonist injection authorised by the MHRA for chronic weight management
With this understanding of GLP-1s role in metabolism and the distinction between transient secretion and sustained activation, we can now evaluate what GLP-1 booster supplements actually containand whether they deliver on their marketing promises
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