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Its effects persist for days, meaning the stomach remains sluggish even if a patient fasts for 812 hours before a procedure

Personalized Metabolic Programs

For anyone on levothyroxine, separate dosing from the injection, keep levothyroxine dosing fasted and consistent, and recheck TSH, as absorption can be sensitive to changes in gastric motility

Particular caution is warranted with insulin (hypoglycemia risk), sulfonylureas (hypoglycemia risk), blood thinners like warfarin (altered absorption), and oral contraceptives (potentially reduced efficacy)

First, GLP-1 receptor agonists can reduce B12 absorption over time by altering gastric acid secretion