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In Gaugler J

The important word here is slowly

Iron deficiency anemia typically produces pallor rather than dark spots, but B12 deficiency has been associated with diffuse lip hyperpigmentation in clinical literature

This leaves much less unabsorbed L-carnitine for the gut bacteria to convert into smelly TMA

Physical recovery from exercise or injury: Exercise is great, but it traumatizes muscle cells

FDA has issued a box warning of the risk of thyroid cancers and are contraindicated liraglutide, exenatide (once weekly), and semaglutide (both oral and injectable) in patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia types 2 A or 2B [135, 136]