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Taken together, the figure highlights a key mechanistic principle underlying the therapeutic rationale for multi-agonist strategies: while GLP-1R monotherapy achieves meaningful metabolic and hepatic benefits exclusively through indirect, systemic pathways, the addition of GIPR and - most importantly - GCGR co-agonism introduces complementary and increasingly direct hepatic mechanisms, providing the pharmacological basis for the superior efficacy observed with dual and triple agonists in MASLD/MASH

If you don't eat animal products, you can change your diet to include vitamin B12-fortified breads and cereals or B12 supplements

doi: 10.3389/fphar.2023.1147414 Received 18 January 2023 Accepted 22 February 2023 Published 02 March 2023 Volume 14 - 2023 Edited by Zhihao Liu, Dalian Medical University, China Reviewed by Ral Gonzalez Ojeda, University of Galway, Ireland Hang Liu, University of California, Los Angeles, United States Updates Copyright 2023 Pei, Pan, Wei and Hua

However, there are a few plant-based sources of L-Carnitine, although they are not as rich in amino acids as animal-based sources

None of the component peptides (BPC-157, TB-500, GHK-Cu) are FDA-approved