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This matters mechanistically because pulsatility is a key feature of physiologic GH signaling

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It would remain the responsibility of Primary Care to diagnose and treat B12 deficient patients but they would have to choose to

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Compared with unexposed pregnancies, the GLP-1 RA-exposed group had a higher risk for excess gestational weight gain (risk ratio, 1.32), greater mean birth weight percentile (58.4 versus 54.8 percent), and a higher risk for preterm delivery, gestational diabetes, and hypertensive disorders of pregnancy (risk ratios, 1.34, 1.30, and 1.29, respectively)