Seek prompt medical advice if you experience: Severe or rapidly worsening joint pain that significantly impairs function or mobility A hot, swollen, very painful joint with fever this could indicate septic arthritis requiring SAME-DAY emergency hospital assessment Symptoms of severe allergic reaction after B12 injection (breathing difficulty, facial/tongue swelling, widespread hives, dizziness/collapse) call 999 immediately Systemic symptoms such as unexplained weight loss, night sweats, or profound fatigue Neurological symptoms including weakness, numbness, balance problems, or cognitive changes Symptoms affecting multiple joints simultaneously, particularly if symmetrical (both hands, both knees) Morning stiffness lasting more than 30 minutes , which may suggest inflammatory arthritis Your GP will conduct a thorough clinical assessment, including detailed history-taking and physical examination

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doi: 10.1093/ajcn/87.1.142
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323,324,325 Specifically, activation of GLP-1R leads to an increase in cAMP levels, which in turn activates PKA, a widely regulating enzyme of cellular functions, capable of phosphorylating a variety of target proteins, thereby initiating the PKA/CREB signaling pathway