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This makes injections highly effective for pernicious anaemia and other malabsorption syndromes, including post-gastrectomy states, Crohn's disease affecting the terminal ileum, and certain medications that interfere with B12 uptake

This means consistent use over multiple cycles can continue to produce benefits without needing to increase the dose

Apply gentle pressure with a clean cotton ball or gauze

Monitoring schedule Healthcare providers who specialize in GLP-1 therapy typically recommend this monitoring cadence: Baseline: Full B12 panel before starting semaglutide 3 months: Repeat serum B12 and MMA 6 months: Full panel reassessment Annually: Once stable, annual monitoring is usually sufficient For high-risk patients (metformin users, vegans, those over 60, post-bariatric surgery), the 3-month check is particularly important