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When to consider adjusting your GLP-1 dose Sometimes constipation is severe enough that it affects quality of life despite implementing all the strategies above

Some high risk groups for vitamin B12 deficiency include: elderly people- often stomach acid production decreases with age individuals who have had intestinal surgery such as weight loss surgery or laparoscopies individuals with GI issues including celiac disease, IBD, IBS (MOST OF YOU!!!) those following a vegetarian or vegan diet- due to the lack of animal protein eaten (one of the main sources of B12) individuals with pernicious anemia- do not make intrinsic factor Notice how a fair amount of the high risk individuals are those with some sort of intestinal issue

Session duration and course length vary by protocol

MHRA guidance Human Medicines Regulations 2012, Regulation 279

Holtzman DM, Carrillo MC, Hendrix JA, Bain LJ, Catafau AM, Gault LM, et al

Some are also approved for a liver condition known as metabolic dysfunction-associated steatohepatitis (MASH)