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Nitrous oxide changes the cobalt core to a different form, which keeps Vitamin B12 in the off position

Verification with serum methylmalonic acid and/or serum homocysteine level may be necessary in asymptomatic patients with high-risk conditions, symptomatic patients with low-normal levels of vitamin B 12 (200 to 350 pg per mL), or symptomatic patients in whom vitamin B 12 deficiency is unlikely but must be excluded

A phase 3 bardoxolone methyl evaluation in patients with chronic kidney disease and T2DM (BEACON) trial (NCT01611569) in 2185 patients with T2DM and stage 4 chronic kidney disease showed that BAR transiently increased eGFR and reduced urine albumin-to-creatinine ratio

Interestingly, DSIP doesn't bind directly to opioid receptors like morphine or endorphins

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