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Individuals who have had gastrointestinal surgery, such as weight loss surgery, may also have fewer cells through which to secrete stomach acid and intrinsic factor, inhibiting B12 absorption

Sympathetic nervous system activation Beyond the direct receptor effect, semaglutide also engages the sympathetic nervous system through central GLP-1 receptor activity in the brain

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68, 69 PPA and related short-chain fatty-acids (that is, butyrate and acetate) have broad effects on cellular systems