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Endotoxemia Lipopolysaccharide (LPS) is a major component of the outer membrane of all gram-negative bacteria that can trigger the synthesis and release of pro-inflammatory cytokines such as TNFα, interleukin 1β (IL-1β), and inducible nitric oxide synthase (iNOS) (Zhang et al., 2000

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Would you say to someone who eats meat and can absorb B12 (which a PA patient can’t do because they have no intrinsic factor): “Oh you can’t eat meat to get your B12 until Monday even though you are B12 deficient on Friday?” This is unreasonable