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Medications Some medications can reduce B12 absorption, such as metformin (for diabetes) and proton pump inhibitors (PPIs) used to treat acid reflux

Insulin receptor substrate 2 expression and involvement in neuronal insulin resistance in diabetic neuropathy

IGF pathways are involved in both anabolic signaling and tumorigenesis, highlighting the importance of dose control and periodic cycling. Pollak, Nature Reviews Cancer Desensitization Overuse can lead to IGF1 receptor downregulation, blunting the bodys natural anabolic response over time

doi: 10.1203/00006450-199803000-00001 122 GonzalesLWGuttentagSHWadeKCPostleADBallardPL