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Long-term use of metformin (for type 2 diabetes) or proton pump inhibitors can also deplete B12 levels over time

Some people do not absorb B12 efficiently due to age, gastrointestinal issues, or insufficient intrinsic factor, a protein required for B12 absorption

Many patients experience fatigue, nausea, or reduced appetite while on GLP-1 or GIP + GLP-1 peptides

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Pregnancy Cyanocobalamin is a medication of the FDA pregnancy category C

This mechanism enhances fat metabolism and supports body composition improvement without affecting blood glucose, insulin sensitivity, or IGF-1 levels like full-length growth hormone would