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Here's where it gets complicated: No-one can agree

Guidelines for the diagnosis and treatment of cobalamin and folate disorders British Society for Haematology

Heidi Seage, Cardiff Metropolitan University An estimated 6% of people in the US and UK suffer from vitamin B12 deficiency

Methylcobalamin B12 is also indicated in those with pernicious anemia, diabetes, neuropathy, heart disease, circadian rhythm sleep disorders, memory loss, depression, fatigue, AIDS, inflammatory bowel disease (IBD), Lyme disease, osteoporosis, tendonitis, psychiatric disorders, Alzheimers disease, liver and kidney disease, and asthma

This overlap makes B12 deficiency easy to miss during GLP-1 therapy, because both the patient and the prescriber attribute these symptoms to the medication itself rather than investigating a correctable nutritional deficit

The need to find new agents for refractory patients has led to the development of mAb-based therapies