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The Neelakantan 2018 paper showed strong oral absorption in cell uptake (Caco-2) assays, which is why most research community use is by mouth instead of by injection

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B12 itself is generally safe, but the side effects often come from the semaglutide

In contrast, DIO mice in both groups switched from WD to LD each had significantly increased Proteobacteria relative abundance (represented solely by the genus Parasutterella ) compared to both the WD and the LD controls, suggesting that Proteobacteria relative abundance may be largely influenced by stress or the differences in net energy expenditure (or associated body weight changes) caused by the diet switch