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Other groups who may benefit include: Patients following gastric surgery (gastrectomy, bariatric procedures) where intrinsic factor production or absorption sites are compromised Individuals with malabsorption disorders such as Crohn's disease, coeliac disease, or chronic pancreatitis Strict vegans and vegetarians with dietary insufficiency, though oral supplementation is usually tried first Elderly patients with atrophic gastritis or reduced gastric acid production Patients on long-term metformin or proton pump inhibitors, which can impair B12 absorption [6] [8] Individuals with nitrous oxide exposure (recreational or medical), which can cause functional B12 deficiency Diagnosis typically involves serum B12 measurement, with levels below approximately 148 pmol/L (though thresholds vary between laboratories) generally indicating deficiency
In clinical trials: Semaglutide: Approximately 7% discontinued due to adverse events Tirzepatide: Approximately 4-7% discontinued due to adverse events (dose dependent) Retatrutide: Approximately 6-10% discontinued due to adverse events (dose dependent) These rates are relatively close, suggesting that despite the differences in mechanism and side effect profiles, all three medications are tolerable for the vast majority of people who start them
Key Takeaways Vitamin B12 is essential for maintaining healthy nerve function
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Screening for Peripheral Neuropathy Screening Methods Screening methods such as the 10-g monofilament test are currently used to detect patients with advanced neuropathy [17]
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