Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease
While there are several types of these receptors, like VEGFR-1, VEGFR-2, and VEGFR-3, it appears that the primary mediator of angiogenic response is most likely VEGFR-2
In the pancreas, semaglutide enhances glucose-dependent insulin secretion, meaning it only triggers insulin release when blood sugar is elevated
Anti-CCP antibodies possess a very high specificity (usually over 90%) for RA and can often be detected years before clinical symptoms arise (Shmerling & Greisen, 2025)
A four-week hold is roughly the window needed for a step to reach steady state and for the gut to adapt to it, which is why escalating before the block is complete effectively means judging a dose you have not yet fully experienced
doi: 10.1093/ajcp/aqx138