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Early observational data suggests that patients on GLP-1 therapy for weight loss may see B12 levels decline by 10-15% over six to twelve months, depending on baseline status and dietary intake

Individuals at risk of vitamin B12 deficiency include older adults, people with gastrointestinal disorders, those who have had gastrointestinal surgeries, individuals on a strict vegan diet, individuals who take metformin for blood sugar control, and people taking proton pump inhibitors for chronic heartburn

GFR 30-49 ml/min: 250-750 mg q12hr

In the UK, these products are regulated as food supplements under food law, not as licensed medicines, and formulations can vary considerably between brands

Recent experimental studies have suggested that moderately elevated homocysteine levels are a causal risk factor for atherothrombotic disease because they affect both the vascular wall structure and the blood coagulation system

Patients with thyroid issues should discuss risks with their doctor