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Sadly, doctors will often stop treatment when B12 levels look high

This acts on centers of the brainstem such as the nucleus tractus solitarius and the area postrema, which, in turn, upregulate the hypothalamus to release hormones which suppress the appetite, such as gastrin and cholecystokinin

In the meantime, mitochondrial dysfunction is induced by hepatic IR and lipid accumulation and the lipid peroxidation mediated by cytochrome p450 2E1 boost the production of reactive oxygen and promote the degradation of mitochondria (125), which could further lead to the lack of cellular energy and metabolic intermediates accumulation, all these may lead to the secretion of pro-inflammatory cytokines, hepatocellular apoptosis and hepatic fibrogenesis, finally resulting in cirrhosis of the liver (125) ( Figure 3 )

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If retatrutide demonstrates resolution of steatohepatitis and improvement in liver fibrosis, it would be one of the first medications approved specifically for this condition