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Severe gastrointestinal disease, particularly gastroparesis or other conditions causing significant delays in gastric emptying, may be exacerbated by treatment with Semaglutide / Cyanocobalamin Injection

The panel will also consider emideltide for opioid withdrawal and chronic insomnia, semax for conditions such as cerebral ischemia, migraines, and chronic pain, and epitalon for insomnia

The Tier 2 supplements include: Vitamin B12 (when serum B12 is below my threshold) Folate (when serum folate or red cell folate is low) Iron (when iron studies show depletion or frank anaemia) Vitamin A (when serum retinol is low) Thiamine (B1) (when whole blood thiamine is low) Vitamin B6 (when PLP is low) Calcium citrate (guided by calcium, vitamin D, and clinical context) Selenium (when selenium is low, more common in post-bariatric patients) The principle is that I do not add these reflexively

Cortisone injections quickly reduce inflammation and offer temporary relief from knee pain and other symptoms