stdei glp-1 mayo clinic reviews Oral Solution Review: Miracle Weight Loss or a Scam? Beyond Ozempic: The GLP-1 boom

This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

You can also try taking over-the-counter acid-reducing medications like famotidine with meals to see if that helps, he says

Exposure to either can cleave parts of the molecule, destroying its biological activity

This review describes available AD drugs and several novel approaches presently being investigated

Blood (2010) 116(14):25829