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The evidence base requires appropriate clinical trials, with additional endpoints including clinical symptoms of patients and additional biochemical parameters beyond plasma B12 levels alone before these alternative routes can be recommended with confidence in clinical guidelines

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Scenario 2: Vegan patient with low-normal b12 considering semaglutide A 38-year-old vegan is prescribed semaglutide

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You're managing two half-lives, two sets of side effects, two storage requirements, and potential interactions that no tox screen has evaluated

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