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I see patients who fail to respond meaningfully to semaglutide even at 1 mg and above, with good adherence and when we switch them to tirzepatide, they still dont respond
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Nasal mucosa contains aminopeptidases and other proteases that cleave peptide bonds before the molecule can cross the epithelium
Some patients use MIC B12 cyclically (12 weeks on, 4-8 weeks off) to assess whether the benefit persists or whether they've corrected the underlying deficiency
The lawsuit was brought by Novo Nordisk A/S and Novo Nordisk Inc
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