Individuals with risk factors for B12 deficiency including strict vegans, those with gastrointestinal conditions, patients taking long-term metformin or proton pump inhibitors, and older adultsshould discuss screening with their GP, even in the absence of obvious symptoms
Oral NAC undergoes first-pass metabolism in the liver, while intravenous administration ensures rapid availability in acute toxicity
GLP-1 receptor agonists semaglutide , tirzepatide , and newer agents like retatrutide and cagrilintide have fundamentally changed how we approach obesity and metabolic disease
However, about 1/3 of patients can lose greater than 5% of the body weight
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Standard fasting requirements (10-12 hours, water only) apply regardless of semaglutide use