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Additional roles of ALDH2: In addition to breaking down alcohols, ALDHD also metabolizes:[ref] Retinol (vitamin A) Bile acids lipid peroxidation products neurotransmitter metabolites Studies link genetic variants in ALDH2 to increased risk of Alzheimers disease, possibly due to the decreased ability to break down lipid peroxidation products in the brain

Semaglutide does not directly affect intrinsic factor production, but the reduced stomach acid environment can compromise the initial separation step that makes b12 available for intrinsic factor binding