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If any step breaks down (low stomach acid, lack of intrinsic factor, or gut inflammation), much of the B12 passes through unabsorbed

Tesamorelin adds preferential visceral fat targeting to the equation

10.1016/j.gene.2018.12.044 148 WangZ.YaoM.JiangL.WangL.YangY.WangQ.et al (2022)

However, its application is limited by volatility and poor buccal bioavailability

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Glucose-6-phosphate dehydrogenase (G6PD) catalyzes the first and committed step oxidation of glucose-6-phosphate to 6-phosphogluconolactone and is the major regulatory enzyme of the branch