The combination is most useful for patients with one or more of the following: BMI of 30 or higher , or BMI 27 with at least one weight-related condition such as type 2 diabetes, hypertension, or sleep apnea History of fatigue, low mood, or brain fog on previous diets or weight loss attempts Metformin use for type 2 diabetes or pre-diabetes (chronic metformin reduces B12) Long-term proton pump inhibitor use such as omeprazole, pantoprazole, or lansoprazole Vegetarian or vegan diet with limited animal protein intake Adults over 50 , where B12 absorption naturally declines Active strength training or higher physical demands while on a calorie deficit Patients who dont fit any of these profiles can still take semaglutide alone, then add B12 if symptoms suggest it
These defects occur early in pregnancy, often before women realize they are pregnant
You may also have an increased risk for vitamin B-12 deficiency if you: recently had weight loss surgery, because the operation interferes with your bodys ability to extract B-12 from food have been diagnosed with Crohns or celiac disease, conditions that can affect the way your body absorbs nutrients are over the age of 50, because the stomach beings to produce less acid as you age, and this acid helps with B-12 absorption take prescribed heartburn drugs, which reduce acid production in your stomach and may affect B-12 absorption If you suspect you have a vitamin deficiency, make an appointment with your doctor
You should also avoid excessive heat, sun exposure, and exercise for the first 24-48 hours post-treatment
Avoid alcohol and anti-inflammatory medications (aspirin, ibuprofen) to reduce the risk of bruising only if safe for you to stop
