Dropping back to the previous dose for two to four weeks and then attempting the escalation again often works
You are aged 60 or over, as stomach acid production decreases with age, reducing B12 absorption from food
this list is not exhaustive Antacids Colchicine (treatment of gout) H2 Blockers (Zantac, Tagamet, Pepcid) Metformin Diabetes drug (Glucophage) PPIs Proton pump inhibitors (Omeprazole, Nexium, Prevacid, Protonix) Nitrous oxide anaesthesia Nitrous oxide recreational abuse (Laughing gas / Whippets / Hippy crack) Mycifradin sulphate (Neomycin) antibiotic Para aminosalicylates antibiotic Phenytoin (Dilantin) anti-epileptic Potassium chloride (K-Dur) Cholestyramine (Questran) Chemotherapy and radiation treatment Increased demands Chronic Hemoltic anaemia Hyperthroidism Multiple myeloma Myelopproliferative disorders Neoplasms Pregnancy Some patients may never find out the cause of their condition, this does not mean that they should be denied B12 injections which are, safe, inexpensive and the most efficient treatment for their deficiency
4 Comparison of change from baseline by week for selected cardiometabolic endpoints for semaglutide versus placebo
a decrease of 4.6 percent
Enhances Metabolism: Aids in fat-burning and weight loss efforts