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However, no randomized controlled trials have tested whether adding glutathione to GLP-1 therapy improves outcomes beyond semaglutide alone

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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

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The MHRA-approved hydroxocobalamin formulation is the preferred injectable form in the UK, as it has a longer duration of action compared to cyanocobalamin