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While researchers found that GLP-1 drugs collectively showed positive impact on managing type 2 diabetes by effectively lowering haemoglobin A1c and fasting plasma glucose levels, higher doses of these drugs were shown to significantly increase adverse gastrointestinal reactions

If you have a B12 deficiency, thats likely the cause for your anemia in the first place

Vigorous shaking can denature the peptide, meaning it can break the fragile bonds that give the molecule its specific shape and function

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PubMed Duzel, A., Vlainic, J., Antunovic, M., Malekinusic, D., Vrdoljak, B., Samara, M., Gojkovic, S., Krezic, I., Vidovic, T., Bilic, Z., Sjekavica, I., Djuzel, A.R., Knezevic, M., Sever, A.Z., Lojo, N., Kokot, A., Sever, M., Drmic, D., Seiwerth, S., Sikiric, P

It involves genetic disposition, environmental triggers, substance abuse and microbial factors