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Your Skin: What you Need to Know GLP-1 receptor agonists Ozempic, Wegovy, Mounjaro have changed the game for weight loss and diabetes management

[13] Wharton S, Haase CL, Kamran E, Liu A, Mancini J, Neish D, Pakseresht A, Power GS, Christensen RAG

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Why This Matters: This isn't just a win for the industry

Others * Long-term metformin use * Proton pump inhibitors (reduce acid absorption) Pathophysiology * Impaired DNA synthesis megaloblastic anemia * Accumulation of methylmalonic acid nerve damage Clinical features Hematological * Fatigue, pallor * Shortness of breath * Megaloblastic anemia Neurological (key distinguishing feature) * Peripheral neuropathy (tingling, numbness) * Loss of vibration and position sense * Ataxia (unsteady gait) * Cognitive changes Severe untreated cases irreversible nerve damage Others * Glossitis (smooth, beefy red tongue) * Mild jaundice Investigations * Serum vitamin B12 * CBC macrocytic anemia ( MCV) * Blood film hypersegmented neutrophils * methylmalonic acid (specific for B12 deficiency) * homocysteine Differentiate from folate deficiency * Both megaloblastic anemia * Only B12 neurological symptoms Management Replacement therapy * Hydroxocobalamin (preferred IM) * Frequent doses initially, then maintenance * Oral B12 if mild and absorption intact Important rule Never give folate alone if B12 deficiency is possible may worsen neurological damage Prevention * Adequate diet (meat, eggs, dairy) * Supplementation in vegans * Monitor high-risk patients (elderly, post-surgery)

In recent days, Hims & Hers Health expanded its platform so clinicians can prescribe Eli Lilly GLP1 weight loss treatments, such as Zepbound vials, KwikPen, and Foundayo, with fulfillment routed through LillyDirect, while also broadening access to Novo Nordisk therapies and strengthening peptide capabilities via a facility acquisition ahead of an FDA review on compounding