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Methylmalonic acid (MMA) test: Methylmalonic acid test detects elevated levels of MMA, a compound that increases when there is a deficiency of vitamin B12
They achieve this by curbing appetite, slowing digestion, and improving insulin sensitivity
Timestamps 00:00:00 Cold open: the man who couldnt stop gaining weight 00:01:49 Meet the case (and the rules of the game) 00:02:36 The presentation: 21, headaches, unexplained weight gain 00:03:57 Austins one-liner and how a clinician builds a differential 00:05:10 Secondary headaches: what raises the red flag 00:13:12 The exam: vitals, and the eye findings that matter 00:14:37 The labs, one number at a time 00:16:08 Raised pressure and a visual-field clue (bitemporal hemianopia) 00:20:45 The MRI 00:21:54 First diagnosis: craniopharyngioma 00:25:32 The name: a tumor built from tooth tissue 00:25:50 Surgery, and what it costs 00:27:43 The new mystery: gaining weight faster than ever 00:33:41 Second diagnosis: acquired hypothalamic obesity 00:39:17 How your brain sets your weight: the POMC brake and the AgRP accelerator 00:42:07 What about leptin
If severe, persistent, or accompanied by red-flag signs, contact your clinician
The GLP-3 peptide research and triple-agonist medications like retatrutide point to a future where multiple receptor targets are activated simultaneously
