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Semaglutide does not directly affect intrinsic factor production, but the reduced stomach acid environment can compromise the initial separation step that makes b12 available for intrinsic factor binding

doi:10.1302/2046-3758.81.BJR-2018-0164.R1 (4) USADA

Interesting biology does not always equal meaningful clinical outcomes

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Compounded semaglutide dosing typically follows a similar schedule to FDA-approved versions, starting with the lowest dose and gradually increasing the dose under the guidance of a healthcare provider

Adverse reactions that occurred more frequently with EGRIFTA relative to placebo and had an incidence 1% during the first 26 weeks across all studies are presented in Table 1