Standard treatment metformin, the oral contraceptive pill, spironolactone manages symptoms
The severity peaks during dose escalation for a physiological reason: receptor density in the area postrema exceeds that in peripheral tissues, so central effects hit harder and faster than metabolic benefits
(The P in GLP-1, the wildly popular category of diabetes and weight-loss drugs that includes Ozempic, stands for peptide.) But many of the substances people are using to self-treat, with names like BPC-157 and TB-500, show promising effects in animal studies but have not been rigorously studied in humans, raising questions about whether they are safe and work as advertised
doi:10.1111/j.1365-2885.2004.00600.x
The original process starts when B12 acts as a cofactor for enzymes crucial to the Citric Acid (Krebs) Cyclethe biochemical pathway that turns nutrients into ATP, our cellular energy currency