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Long-term metformin or proton pump inhibitor (PPI) users These medications can interfere with B12 absorption over time

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The medication is used for a wide range of indications

We also observed no changes in viability, cell size, activation marker expression, or proliferation in CD4 + T cells activated in the presence of insulin or IGF-1 (Supplementary Fig

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Over years of study, it has demonstrated a strong safety profile, including: No negative impact on glucose metabolism No antibody formation in monitored trials No serious adverse events linked to its use A tolerability profile similar to placebo These findings support its long-term use within medically supervised weight loss programs