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Altered gut microbiota can signal through pattern recognition receptors on gut epithelial cells, activating the NF-B pathway and leading to changes in gut homeostasis [122]

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Los eventos adversos (EA) fueron principalmente gastrointestinales (79,6% en el grupo de CagriSema frente al 39,9% con placebo), incluyendo nuseas (55% frente a 12,6%), estreimiento (30,7% frente a 11,6%), vmitos (26,1% frente a 4,1%) y fueron en su mayora transitorios y de leve a moderada gravedad

There are other bullet points on this page but here they state evidence based guidance. Id like to know what evidence backs up this particular set of DO NOT DO RECOMMENDATIONS for CFS and ME patients

Along with increased energy, other immediate effects of B12 shots include improved mood and alertness