Baseline and ongoing monitoring: Before initiating GLP-1/GIP therapy, consider measuring baseline B12 levels, particularly in patients concurrently taking metformin, those with previous bariatric surgery, individuals following plant-based diets, or those with malabsorption conditions
Prakash S, Dhanushkodi NR, Zayou L, Ibraim IC, Quadiri A, Coulon PG, et al
The evidence is overwhelming, consistent, and reproduced across thousands of subjects in multiple rigorous trials
Upon receiving the medication, it should be stored in a refrigerator at 36F to 46F (2C to 8C)
The common systemic features reported were fatigue, glossitis, weight loss and anorexia that was found in 34%, 31%, 27% and 22% of cases respectively.[4] Hyper pigmentation of skin has been reported only rarely as the presenting manifestation of vitamin B12 deficiency as found in this patient.[5] There are only two such Indian reports found in Indian literature.[6,7] After the treatment, hematologic response begins after several days and, moreover, the final hematologic landmark is the blood count, including mean corpuscular volume (MCV) that should be completely normal by the eighth week.[8] The cutaneous manifestation of vitamin B12 deficiency is skin hyper pigmentation, vitiligo, hair changes, and recurrent angular stomatitis