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The intestinal epithelium together with gut-associated lymphoid tissue and the neuroendocrine network work at regulating transport of environmental or dietary antigens from the intestinal lumen into the sub-mucosa.[2] Dysregulation of the mucosal barrier leads to leakiness of antigens and other macromolecules into the host to initiate systemic inflammation and immune activation which in turn influences tolerance and immunity

Women with balanced diets containing animal products typically obtain sufficient B12 from food alone

However, tirzepatide demonstrates a dose-dependent effect on glycaemia: at 5 mg once weekly, 27% of people with type 2 diabetes achieved an HbA 1c below 5.7%, compared with 46% at 15 mg once weekly

The main limiting side effects are nausea, vomiting, constipation, and appetite suppression that becomes too strong

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