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As it is not naturally present in fruit, vegetables, and grains, vegans may not get sufficient amounts of vitamin B12 in their diet

The combination is most useful for patients with one or more of the following: BMI of 30 or higher , or BMI 27 with at least one weight-related condition such as type 2 diabetes, hypertension, or sleep apnea History of fatigue, low mood, or brain fog on previous diets or weight loss attempts Metformin use for type 2 diabetes or pre-diabetes (chronic metformin reduces B12) Long-term proton pump inhibitor use such as omeprazole, pantoprazole, or lansoprazole Vegetarian or vegan diet with limited animal protein intake Adults over 50 , where B12 absorption naturally declines Active strength training or higher physical demands while on a calorie deficit Patients who dont fit any of these profiles can still take semaglutide alone, then add B12 if symptoms suggest it

The break is a hedge against an unknown, not a pharmacological requirement

The recommended daily intake for adults in the UK is 1.5 micrograms , according to NHS guidance

[5] Peptides such as AOD 9604 and retatrutide, when sold with implied therapeutic claims (e.g., fat loss, metabolic enhancement), may legally constitute unlicensed medicinal products, regardless of how they are labelled by suppliers

This drug has not been approved for managing migraine on the PBS but can be purchased on a private prescription at quite a monthly cost