Semaglutide and other GLP-1 agonists actually improve glucose metabolism but work through appetite suppression rather than direct fat cell targeting
Those on metformin, proton pump inhibitors, or H2-blockers may have reduced B12 absorption and should be tested before and periodically during treatment
Phase 2: Introduce AOD 9604 (weeks 5-8) Once tirzepatide is tolerated at the initial dose, add AOD 9604 at 250mcg daily
The vital nutrient is found in the highest concentrations in meat, seafood, and eggs, and it is sometimes added to fortified foods like breakfast cereals, according to Harvard Health Publishing
However, many MCAS patients are highly sensitive to standard methylated B12 (methylcobalamin), which can trigger severe symptom flares