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In the stomach, hydrochloric acid and enzymes unbind vitamin B12 into its free form

Naltrexone also affects dopamine and serotonin pathways, neurotransmitters involved in appetite and mood regulation

[1] [3] Understanding these multisystem effects is essential when evaluating potential adverse effects, including fatigue, as the widespread distribution of GLP-1 receptors means these medications influence numerous physiological processes beyond glucose metabolism

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