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Lifestyle Factors In every trial that defines this molecule, larazotide was an adjunct to a continued gluten-free diet the strict avoidance of gluten remained the foundation, and the peptide was layered on top for patients who stayed symptomatic despite that diet [4]

[21] [22] This condition impairs B12 absorption in the terminal ileum and typically requires lifelong parenteral replacement therapy

Understanding these pathways helps explain why the peptide shows such broad therapeutic potential across different tissue types

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Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives