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It is also important to ensure adequate folate levels through supplementation, if appropriate, once vitamin B12 supplementation has been commenced to avoid precipitating subacute combined degeneration of the spinal cord[2]

Second, while this study proposes a mechanistic hypothesis based on proteomic findings, future studies using immunohistochemistry and cellular co-localization are needed to identify the cellular sources of CINC-3 and CNTF expression and clarify DPs cellular targets.Thirdly, this study is the absence of behavioral assessments such as von Frey test, weight bearing, or gait analysis, future studies will incorporate these approaches to further investigate the functional implications of the molecular changes observed

Oral supplements, on the other hand, are taken as tablets or liquids and must pass through the stomach and intestines, where absorption can be slower and weaker, especially for patients with digestive problems

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While some patients report vasomotor symptoms during treatment, there is no established pharmacological mechanism directly linking tirzepatide to hot flashes