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In this review, we evaluated the overall changes to the intestinal flora alongside variations to the specific strains within the microbiota and established their association with PPI-related digestive disorders whilst detailing all possible mechanisms of action involved in this relationship (Figure 3)

four compounds with complementary healing and anti-inflammatory mechanisms targeting tissue repair, gut healing, collagen synthesis, and cytokine modulation

Rarely reported symptoms associated with excessive B12 intake may include: Skin reactions : Acne-like eruptions or rosacea-type dermatitis have been occasionally reported, particularly with high-dose intramuscular injections Gastrointestinal disturbance : Mild nausea, diarrhoea, or abdominal discomfort, though these are uncommon Headache : Infrequent reports of headaches following parenteral B12 administration Hypersensitivity reactions : In very rare cases, allergic reactions to injectable B12 preparations have been documented It is crucial to note that there is no established link between standard B12 supplementation and serious adverse effects

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FDA status and availability timeline Neither cagrilintide nor retatrutide is currently FDA approved