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This non-linear dose-response is characteristic of peptides that operate through receptor saturation rather than systemic hormonal signalling

This includes vegans and vegetarians, older adults, individuals with atrophic gastritis, pernicious anemia, gastrointestinal disorders, those who have had gastrointestinal surgery and people who take certain medications including, but not limited to, estrogen (HRT), and birth control pills

None of these pathways directly substitute for another, which is part of why researchers interested in a fuller picture of metabolic regulation may look at all three within the same body of literature not to combine effects, but to understand how separate systems might interact at a mechanistic level

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High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease