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Strong evidence, from decades of treating individuals with inborn errors of B 12 metabolism, supports the safety of parenteral, lifelong, even high dose hydroxocobalamin, sometimes even at very high doses

Patients should be encouraged to engage in regular moderate-intensity exercise, starting with short durations (10-15 minutes) if necessary and gradually increasing

Oligosaccharides also pull double duty by serving as anti-adhesives that block microbial attachments to the gut epithelium and stimulate gut epithelial immune cells to improve immune response

5A-1MQ-treated mice switched from WD to LD (WD/LD-T) showed a rather reduced relative abundance of Akkermansia compared to vehicle-treated DIO animals switched from WD to LD (WD/LD-V), suggesting a unique microbiome mechanism associated with weight loss in the vehicle-treated group switched from WD to LD compared to the 5A-1MQ-treated group that underwent the same diet switch