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For patients whose levels fall in the borderline or gray zone, a methylmalonic acid (MMA) test provides greater specificity MMA levels rise when B12 is functionally inadequate at the cellular level, even if serum B12 appears borderline normal

Escalate: Increase by 2.5 mg every 4 weeks as tolerated

Ozempic is given as an injection under the skin and comes in an injection pen

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Semaglutide is engineered to resist that degradation, extending its half-life to approximately seven days, which is why it only requires once-weekly dosing

Six trials involving approximately 900 participants confirmed no treatment-related serious adverse events, no IGF-1 elevation, no cardiovascular events, and no immunogenic response