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Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team
However, proper dosing is still important
no Phase II or III trials published Most common AOD-9604 side effect / Injection-site reaction (redness, swelling) Most common reported MOTS-c side effect / Transient flushing and mild GI discomfort (anecdotal, not trial-confirmed) Growth hormone axis impact / AOD-9604 does not activate the GH receptor
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