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In addition estrogens are also involved in the regulation of energy expenditure and food intake and have been reported to protect pancreatic cells from various injuries as well as enhancing insulin biosynthesis through activation of the estrogen receptor (74)

It's not clear how you get PA, though genetic and environmental factors may play a role

In cell culture assays addition of CART peptides results in phosphorylation of extracellular signal-regulated kinase (ERK) as well as the transcription factor, cyclic AMP response element binding protein (CREB)

J Dairy Sci

I add this meaning since the study below and the following audits, had the very opposite effect on preventing illness in B12 deficient patients.) This report states

Its safety comes from its biochemistry, not from marketing claims about naturalness