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For patients with clinical deficiency, effective replacement therapy should lead to a normal blood count after two months of treatment, while improvement in neurologic symptoms begins within one week after initiation of therapy and is usually complete within 6 weeks to 3 months.13 For patients with an asymptomatic biochemical deficiency (ie, subclinical disease), measurement of serum B12 or MMA levels should be done 2 to 3 months after initiation of replacement therapy.12 Once metformin is started, this medication is seldom discontinued unless advanced renal impairment develops

Tesamorelin: Another growth hormone-releasing hormone analog studied specifically for visceral fat reduction

B12 injections are also used to treat people with malabsorption (gastrointestinal conditions that prevent proper absorption of B12 from the gut), for example, people with atrophic gastritis (stomach inflammation) and intrinsic factor deficiency (pernicious anemia) or those who have undergone surgical procedures such as gastrectomy or small bowel resection (stomach or intestine removed), autoimmune diseases, etc

This is still early-stage research, but it represents a logical evolution of the FTPP concept

SEQUENCE: Tyr-Leu-Arg-Ile-Val-Gln-Cys-Arg-Ser-Val-Glu-Gly-Ser-Cys-Gly-Phe

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