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This contrasts with oral semaglutide, where adherence to the strict fasting protocol is essential for achieving therapeutic drug levels, and where deviations from the protocol (such as taking the medication with food or excessive water) can substantially reduce efficacy

Most people are not at risk for B12 deficiency, Selvi Rajagopal , M.D., M.P.H., assistant professor of medicine at The Johns Hopkins University School of Medicine, tells Runners World

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Some people may also experience adverse effects like mild diarrhea, itching, or a swelling sensation in the body