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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

If nausea onset coincides with 5-amino-1MQ introduction but tirzepatide dose was stable for 4+ weeks prior, the new compound is the likely culprit

Statements Author contributions TB: Writing original draft, Writing review and editing, Conceptualization

That is one of the biggest take home messages because we don't want everyone who gets this reaction to be using antibiotics unnecessarily, Blumenthal added

An FDA peptide review is scheduled for July 2324, 2026, and it could shape how some of the most-studied peptides in regenerative and longevity medicine are accessed going forward