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The potential hepatotoxicity of herbal products has also been recognized in recent years (Stickel and Shouval, 2015)

MHRA-approved options include orlistat (prescription and over the counter), semaglutide (Wegovy, supported by NICE TA875), and liraglutide (Saxenda, supported by NICE TA664)

Different compounds in the sample interact with this material to varying degrees, causing them to travel through the column at different speeds

Some PA patients appear to be able to respond to 'mega-doses' of oral B12 however, but this situation needs very careful management because it's not yet possible to work out who will benefit without a clinical trial