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Special Populations Females have approximately 25% higher exposure to active metabolite than males

Competing interests The authors declare that they have no competing interests.

Aratrma: Broad et al., 2008 Nutrition & Metabolism L-Carnitinein kardiyo ncesi kullanm ya yakmn artrrken, kas ktlesine zarar vermedii gzlemlenmitir

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Summary: NICE guidance advises against combining Trulicity (a GLP-1 receptor agonist) and Januvia (a DPP-4 inhibitor), recommending that DPP-4 inhibitors be discontinued when starting GLP-1 receptor agonists

Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8