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(PubMed) Oliai Araghi S, Kiefte-de Jong JC, van Dijk SC, et al

When elevated levels are identified, systematic investigation is required to determine the underlying cause

It must be considered that multiple factors interact to control IGF-1 levels, many of which are disturbed in T2D, namely: increased inflammatory cytokines, decreased hepatic insulin action due to resistance, concomitant changes in IGFBPs, and the effects of obesity

Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacterial overgrowth, total or partial gastrectomy

If there was an excess of cobalt then it would be passed by the animal

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