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Though the exact mechanism through which increased actions of GLP-1 receptor agonists can influence foetal development is not clearly established, evidence of the presence of GLP-1 receptors in foetal tissue, as well as perturbation of hormone signalling in cases of hGH administration, makes this concern understandable, taking into account that available evidence obtained from human studies is still lacking
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However, patients with polycythemia vera, Leber hereditary optic neuropathy, or certain cyanide-related metabolic conditions require careful medical evaluation before adding B12
