And so a lot of clinicians who wanted to microdose would use a compounding pharmacy to prescribe those medications and allow patients more flexibility on how they dose their GLP-1
What Happens When You Eat Meat Timeline After Eating Meat (e.g., 100g beef containing ~2-3 mcg B12) Hour 0: You Eat the Meat B12 is bound to proteins in the meat Enters stomach Hour 0-2: Stomach Processing Stomach acid and pepsin release B12 from protein B12 binds to R-proteins (haptocorrin) secreted in saliva and stomach This B12-R-protein complex is acid-stable Moves to the small intestine Hour 2-4: Small Intestine Absorption Pancreatic enzymes degrade R-protein Intrinsic factor (from the stomach) binds to free B12 B12-intrinsic factor complex travels to the terminal ileum Absorption occurs in the terminal ileum via specific receptors KEY POINT: This process takes 4-8 hours minimum absorption is NOT immediate Hour 4-8: Absorption into Blood B12-intrinsic factor complex binds to cubilin receptors in the ileum B12 crosses the intestinal wall Enters portal circulation Goes to the liver first (first-pass through the liver) Hour 8-24: Liver Processing and Distribution The liver takes up much of the absorbed B12 Binds to transcobalamin II (active carrier) and haptocorrin (storage carrier) Released slowly into systemic circulation Peak serum B12 levels: 8-24 hours post-meal (not immediate!) EXPERIMENTAL SCENARIO: Testing Before and After Meat Scenario 1: Test Immediately After Eating Timeline: T = 0: Baseline B12 test drawn Result: 300 pg/mL T = 10 minutes: Eat a large steak (200g, ~5 mcg B12) T = 30 minutes: Retest B12 Expected Result: No significant change Still ~300 pg/mL Why
For prescribers, the shift is already obvious in the exam room: patients are arriving with questions about topical finasteride, compounded minoxidil formulations, and multi-agent combinations they found through telehealth platforms or social media
Signs suggesting adequate treatment include plateau in improvement for two or more weeks, significant resolution of primary concerns, and strong improvement maintained during previous breaks
Fu, X., Jin, L., Ma, P., Fan, Z
