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[4] The second activation step takes place predominantly in the kidneys where 1-hydroxylase converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D (calcitriol), an active secosteroid hormone that binds nuclear receptors in enterocytes, osteoblasts, renal tubules, parathyroid cells, and numerous immune and endocrine cells to modulate hundreds of genes involved in calcium-phosphate homeostasis, skeletal remodelling, and immunoregulation
Access to all licensed weight management medicines through the NHS is subject to NICE eligibility criteria and local commissioning decisions
This 12x increase in consumption is the primary driver of retatrutide cost escalation over a protocol
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