"Pernicious Anemia", StatPearls , Treasure Island (FL): StatPearls Publishing, PMID 31082033, retrieved July 15, 2025 "Vitamin B12 or folate deficiency anaemia Diagnosis"
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Compounding pharmacies typically use cyanocobalamin when creating semaglutide with b12 formulations
Formulation alternatives may provide relief: Different tablet formulations with alternative inactive ingredients may be better tolerated Liquid preparations can be easier to tolerate and allow flexible dosing Intramuscular injections completely avoid the gastrointestinal tract and are particularly useful for those with absorption issues (such as pernicious anaemia or malabsorption) or persistent oral intolerance Review inactive ingredients: Examine the supplement label for potential irritants or allergens
Vitamin B 12 replacement is safe and without side-effects, but prompt treatment is required to reverse the damage before it becomes extensive or irreversible
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