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A patient with PA presents lower than normal amounts of intrinsic factor

Regarding ERT, efficacy is greatly conditioned by the initiation age, approved enzymes have low tissue penetration and none of them crosses the bloodbrain barrier (BBB), administration causes infusion associated reactions and may induce the production of anti-drug antibodies with neutralizing effect, requires lifetime i.v

If your genetic profile suggests heightened GLP-1R sensitivity, your provider might recommend slower titration, microdose protocols, or oral formulations to minimize nausea risk