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While direct cortisol measurements were not specifically reported in the published safety trials, the comprehensive metabolic monitoring across 900+ participants showed no clinically significant hormonal changes, and the mechanism of action provides no pathway for cortisol stimulation

(Lin et al., 1993)

Search strategy We conducted searches in Medline, Extended Medline (1950 to 22 July 2020) using the following search words (Vitamin B12 or Cobalamin or Methylcobalamin or Cyanocobalamin) and (Autism, Autistic spectrum disorder or attention deficit hyperactivity disorder or ASD or ADHD)

(31) Discussion The findings from this literature review suggest that GLP-1 receptor agonists influence bone metabolism, wound healing, and surgical outcomes, with both preclinical and clinical evidence supporting potential benefits in orthopedic settings