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Around half of patients with pernicious anaemia are anti-intrinsic factor negative

A comprehensive battery of laboratory tests could be obtained both at baseline and, with the exception of genetic tests, at defined intervals once treatment had been initiated (eg, MMA, Hcy, holoTC, a full CBC, IF antibodies, ferritin, serum iron/total iron binding capacity, serum folate, RBC folate, and sequencing of the TCN1 and TCN2 genes)

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For those who fall outside these categories and have normal serum B12 levels, an injection is a discretionary wellness choice not a medical treatment

Inform them you've started semaglutide so they interpret results in context