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In addition, some putative effects of GLP-1RAs on cognitive and mental health symptoms may not require direct activity in the CNS, but rather be mediated by the actions that these medications express in the periphery across immune, endocrinemetabolic and gutbrain axis mechanisms (Fig

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The metabolic effects of metformin vary somewhat across gram-negative bacteria: (1) in E coli metformin inhibits respiratory chain complex I, impairing the function of the inner membrane vitamin B12 transporter (BtuCD), so vitamin B12 entry is blocked at the inner membrane, causing vitamin B12 to accumulate in the periplasm

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