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Akt is the principal mediator of IGF-1s pro-survival, anti-apoptotic, and anabolic effects: it phosphorylates and inhibits pro-apoptotic factors, activates the mechanistic target of rapamycin complex 1 (mTORC1) to drive protein synthesis, and suppresses the FOXO transcription factors that promote muscle atrophy and proteolysis

When pernicious anaemia is suspected, testing for anti-intrinsic factor antibodies (and sometimes anti-parietal cell antibodies) is recommended

in the absence of sponsor-validated data, the solution should be used immediately or discarded

A balanced and varied diet and a healthy lifestyle are recommended