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From the bottom of my heartthank you, Dr

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The primary injury results in localized brain damage, while the secondary damage initiates inflammatory responses, followed by the disruption of the blood-brain barrier, infiltration of peripheral blood cells, brain edema, and the release of various immune mediators, including chemotactic factors and interleukins

But the problem here is that the science needed to prove that some patients with Pernicious Anaemia, that is who have a problem absorbing B12 in their stomach need enormous amounts of replacement B12 is simply not there yet

For tirzepatide, with a similar half-life, the same guidance applies