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In such cases, B12 injections bypass the gastrointestinal tract, directly increasing vitamin levels and helping alleviate symptoms like fatigue and neurological issues

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The decision to continue, adjust, or discontinue therapy should be based on objective body composition measurements (DEXA scans, circumference measurements), achievement of fat loss goals, tolerance and side effect profile, and physician assessment of metabolic markers

Its imbalanced receptor affinity and biased signaling provide enhanced insulin secretion and improved metabolic outcomes beyond selective GLP-1 agonism

Higher-dose oral B12 (e.g., 1000 g daily) is sometimes used but should only be considered under clinical supervision with appropriate monitoring, particularly in cases of malabsorption where intramuscular treatment remains the first-line approach in UK practice

H., Szczeciska A., Dhonukshe-Rutten R