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Patients frequently report an energy change in the first day or two, which is most plausibly B12 in deficient patients, and expectation in everyone else
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Specifically, GLP-1RAs reduce SREBP-2 expression via activation of the SIRT6-AMPK pathway, resulting in decreased expression of cholesterol and bile acid synthesis genes, and increased expression of genes associated with RCT and LDL-C uptake
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