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L-Glutathione (GSH), especially in nanoparticle slow-release form, maintains redox tone but excessive co-delivery creates a reductive stress, paradoxically inactivating Nrf2, SIRT3, and AMPK, the very genes responsible for antioxidant renewal

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Additionally, some individuals taking Mounjaro may have pre-existing conditions that independently increase their risk of B12 deficiency, such as previous bariatric surgery or concurrent metformin use (the MHRA has highlighted that metformin can reduce vitamin B12 levels)