Similar to cagrilintide, pramlintide is primarily eliminated via the kidneys and, in a pharmacokinetic study in participants with type 1 diabetes, no statistically significant differences were noted in total (AUC 0- ) and peak ( C max ) exposure after administration of a single pramlintide 60 g dose in participants with mild, moderate or severe renal impairment compared with those with normal renal function, although inter-patient variability was high [20]
Additionally, the regulatory mechanisms between other pathways or protein receptors mediating mitophagy and mitochondrial biogenesis require further investigation
Both methods bypass the digestive system, but they differ in absorption speed, nutrient scope, and ideal use cases
doi:10.1046/j.1365-2982.2002.00311.x
A more likely reason for deficiency would be low absorption in the gut, probably because of pernicious anemia or another condition