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Semaglutide, similarly, is characterized as not clinically confirmed as biased GLP1R agonist [52], which preserve acute signaling support while also enabling desensitization pathways [47], which may contribute to clinical observations such as tachyphylaxis of gastrointestinal side effects

High-dose B12 seems promising, mainly for those with a B12 deficiency or at risk

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Many of Hirschs patients resort to creative strategies, like driving from Washington state to Canada to obtain these medications for a lower cost

Additionally, oral bioavailability is a major hurdle