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These drugs work by imitating glucagon-like peptide-1 (GLP-1), a growth hormone that triggers insulin release, reduces blood sugar levels, slows the progress of food along the intestinal track, and stimulates parts of the brain that control craving and satiety
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Interestingly, PPG axons are found in high density in the vicinity of the brain ventricles, and the idea has been posited that PPG neurons might release GLP1 into the ventricles and that receptors away from PPG projections might be reached by some type of volume transmission (Hsu et al., 2015)
Furthermore, open-label trials utilizing high-dose hydroxycobalamin have shown marked clinical improvements in ME/CFS patients, specifically correlating with the vitamin's ability to act as a nitric oxide scavenger
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