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For patients seeking weight loss who request B12 injections, GPs should: Assess for genuine deficiency through appropriate blood tests rather than empirical treatment Provide education about the lack of evidence supporting B12 for weight loss in non-deficient individuals Explore underlying concerns about weight and energy levels, addressing these through appropriate channels Signpost to evidence-based resources such as NHS weight management services according to local pathways Patients should contact their GP if they experience unexplained fatigue, neurological symptoms (numbness, tingling, balance problems), or signs of anaemia (pallor, breathlessness, palpitations), as these may indicate B12 deficiency requiring investigation

The recommended dato-DXd dose is 6 mg/kg, with a maximum of 540 mg for patients with a weight of 90 kg or greater

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In contrast, a study by Teixeira et al [215] reported obese females exhibited higher levels of lactulose excretion but not mannitol than the lean controls

This predictability helps men feel more confident and reduces anxiety during sexual activity