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Reduced food intake can lower nutrient intake, but B12 need should be based on diet, symptoms, metformin use, surgery, gastrointestinal disease, and laboratory assessment rather than the GLP-1 medication alone

At the cellular level, B12 acts as a cofactor for two critical enzymatic reactions: Methionine synthase converts homocysteine to methionine, essential for DNA methylation and synthesis Methylmalonyl-CoA mutase involved in fatty acid metabolism and myelin production By restoring adequate B12 levels, injections enable normal red blood cell maturation in the bone marrow, correcting the megaloblastic anaemia