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Avoid sugary beverages, refined carbohydrates, and high-saturated-fat foods, which can blunt your medication's hormonal effectiveness

Moreover, it has recently been appreciated that emerging approaches to combat obesity by causing profound weight losssuch as with bariatric surgery or glucagon-like peptide-1 (GLP1)-receptor agonistscan often also result in profound muscle loss, with up to 40% of the associated weight loss accounted for by lean mass loss 20,21,22

In the UK, pernicious anaemia is typically treated with intramuscular hydroxocobalamin injections, though high-dose oral supplements may be considered in some cases under clinical supervision

PMID: 17126095

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How often should I reduce my dose