These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance
Several combination preparations of different B 12 forms and combinations with vitamins B 1 and B 6 are available
72 Cyanocobalamin (but not hydroxocobalamin) is also contraindicated in renal insufficiency
Slower absorption When high doses of B12 are injected, the body can only store so much before excess is excreted
Common side effects include injection site reactions (burning, pain, swelling, redness), headache, mild diarrhea, and upset stomach
Early studies on 5-Amino-1MQ show promising results, particularly in animal models
