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However, certain populations are at higher risk of deficiency: Adults over 50 (reduced absorption capacity) Individuals following vegan or strict vegetarian diets Those with gastrointestinal conditions such as Crohns disease or celiac disease Individuals taking long-term acid-reducing medications (PPIs, H blockers) When oral supplementation is insufficient or absorption is compromised, vitamin B12 shots deliver the nutrient directly into the bloodstream, bypassing the digestive system entirely

According to FDA guidance, GLP-1 medications are not recommended for people who have: Pregnancy, because safety data are limited and pregnancy requires appropriate weight gain and nutrient storage A prior history of pancreatitis, due to a risk of triggering inflammation of the pancreas A history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN2), a rare genetic condition linked to thyroid cancer in animal studies A clinician will review your medical history carefully to determine whether these medications are appropriate for you

Initially, main concerns were receptor-activating activity while recently, downstream effects of GLP-1R and GIPR have been more and more revealed that not only receptor activation promotes cAMP and stimulates insulin releasing, but also other factors (-arrestin recruitment, residence time, etc.) influence receptor internalization, which further elicits long-term effects in vivo

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