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While ELISPOT detected no cell-mediated immune response to CEA and HER2, a significant increase in cell-mediated immunity and antibody titers against the bacterial heat labile toxin was noted (Diaz et al., 2013)

To prevent that deficiency, you can either go with vitamin B12 oral supplements or B12 injections

Combining a low-calorie diet with HCG can help boost your metabolism, causing your body to burn through fat, while the B12 helps you to maintain energy levels throughout the day and reduce fatigue HCG and B12 injections, administered together, provide an effective weight loss solution for those in Jacksonville, FL

Taking all this data together it seems logical or appropriate to conclude that, because IGF1-R has a different signalling pathway that can maintain lipid oxidation in the liver, FFA uptake in muscle, and activates mTORC1 could reactivate IR through tyrosine kinase activity on IRS, thus displacing serine phosphorylation, reinstituting insulin signalling