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Clinical reality is different We know from randomised clinical trials that they have positive effects, but clinical reality is different with patients varying in disease severity, comorbidities, and adherence to treatment recommendations, says Bjrn Pasternak

Some people may benefit from protein supplements like powders, bars, and drinks also

In particular, it remains unclear how liver-derived signals such as hepatokines, cytokines, and metabolic intermediates affect central and extrahepatic peripheral clocks, and whether these pathways are causal or merely associative

This is particularly important if you are part of any of the groups considered to be at high risk of B12 deficiency, including alcoholics, smokers, those on diabetes drugs, adults over 65, those with gastrointestinal disorders and those who have had surgery relating to the digestive tract

Individuals with history of pancreatitis Those with a prior history of pancreatitis face elevated risk with any hormonal weight loss compound that affects pancreatic function