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Valtrex is a powerful antiviral that requires careful dosing to be effective and safe

ACS Nano 5 (12), 97729787

This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

Instead, re-esterification of FAs is reduced by 25% in T2D adipocytes leading to increased FA levels (190), suggesting the primary defect may be in sequestration of FAs and not lipolysis per se