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Since semaglutide further slows gastric emptying as part of its mechanism of action, patients with pre-existing gastroparesis may experience worsening of symptoms including nausea, vomiting, bloating, and abdominal discomfort

Medications Some medications can reduce B12 absorption, such as metformin (for diabetes) and proton pump inhibitors (PPIs) used to treat acid reflux

Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey

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Provided as a stable lyophilized powder, it is suitable for controlled research environments requiring precision and reproducibility