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According to a medical textbook, There is no disease described in the human body where conversion of inactive cobalamin to active methylcobalamin is impaired

The TriNetX platform has been used in retrospective cohort studies [25,26,27,28,29,30,31,32,33,34,35,36,37,38] including evaluating risk and health outcomes of patients with substance use disorders including CUD [25, 32, 35] and the associations of GLP-1RAs with cancer [37] and semaglutide with suicidal ideations [38]

Vulnerable populations such as frail patients, pregnant women, adolescents and the elderly may be more susceptible to adverse effects like muscle loss or nutritional deficits

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However, Eli Lilly cautions about the risks and uncertainties in drug development