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The American Academy of Family Physicians and NIH identify the following clinical manifestations: Fatigue and generalized weakness Megaloblastic anemia (abnormally large, immature red blood cells) Tingling or numbness in the hands and feet (peripheral neuropathy) Difficulty walking and balance problems Cognitive disturbances including memory difficulty and confusion Mood changes, including depression and irritability Glossitis (swollen, inflamed tongue) Early symptoms such as fatigue and mild tingling are often attributed to stress, aging, or other conditions

doi:10.36660/abc.20200028 Zheng G, Zheng X, Li J, et al

The shedding is usually temporary, with regrowth occurring once weight stabilizes

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Compounded semaglutide from licensed pharmacies runs $200 to $500 monthly