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The additive effects of combination SGLT2i and GLP-1RA therapy on HbA 1c and weight outcomes have been observed in randomized controlled trials (RCTs), nonrandomized trials, and real-world observational studies
Both oral and injectable GLP-1s have a long half-life (about one week) I typically recommend stopping them at least 2 weeks before surgery This helps ensure proper nutrition, safer anesthesia, and better healing Weight loss drugs are powerful, but surgery requires your body to be well-nourished
Those with diseases that affect the gut, such as Crohns disease or celiac disease, are also at risk ( Summary Those at greatest risk of vitamin B12 deficiency are vegans and vegetarians, who get little to no B12 from the diet
Microbiome, Stress, and Immune Tone Overlaying gut sensory and hormonal signaling is the gut microbiome
B12 is a water-soluble vitamin, meaning any excess is quickly flushed out through the urine
