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[11] [12] Nitrous oxide exposure (medical or recreational) can cause functional B12 deficiency requiring urgent treatment, particularly if neurological symptoms develop

So I still find that using a phenotypic approach even with pharmacotherapy can be very advantageous for the patients because it really rounds out: how do I treat the patient in front of me, even though it's the same medication I use for the past five patients

Furthermore, GLP-1RAs can counteract the diabetes-induced downregulation of the glutamate-aspartate transporter (GLAST), a key glial transporter responsible for clearing extracellular glutamate [57]

Have you tried GLP-1s