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Some disorders of intracellular cobalamin metabolism (cblC, cblD-MMA/Hcy, cblF, and cblJ) do not only compromise the synthesis of methylcobalamin, but also the synthesis of adenosylcobalamin, cofactor of the enzyme methylmalonyl-CoA mutase, leading to elevated concentrations of both tHcy and methylmalonic acid (MMA)

Quality matters more than dose For a peptide used at sub-milligram amounts, batch contamination or aggregation can matter more than a 10-20% dose change

Agonist-modulated palmitoylation of endothelial nitric oxide synthase

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In the SURMOUNT-1 trial, people treated with tirzepatide lost up to 22.5% of their body weight over 72 weeks , making it even more effective than semaglutide (NEJM tirzepatide study)

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