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PMID 16766527

Summary: Elevated vitamin B12 levels rarely cause direct symptoms

Facial fat grafting or hyaluronic acid fillers are typical approaches to replenish volume after significant loss

Many providers recommend a gradual taper or maintenance phase to support a smoother transition, but individual recommendations vary

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These include: Pre-existing constipation or slow transit constipation Inadequate dietary fibre intake Insufficient fluid consumption Reduced physical activity levels Concurrent medications with constipating effects (such as opioids, certain antidepressants, or iron supplements) Older age , where baseline colonic motility may already be reduced The severity of constipation often correlates with the dose of medication and may be more pronounced during dose escalation phases