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Furthermore, decreased bacterial richness has been linked to high carbohydrate 73 and high-fat/low-protein concentrations 74 , as found in the lean and Western diets, respectively, the latter result only in old-aged rats 74

This usually occurs in individuals with underlying digestive conditions, those who have trouble absorbing all nutrients through digestion, or those with pernicious anemia, which specifically prevents B12 absorption

Interestingly, GH signaling leading to activation of lipolysis in adipose tissue and increased hepatic glucose production via both glycogenolysis and gluconeogenesis in the liver, is not affected by the absence of insulin crosstalk (reviewed in (72))