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Published research has associated long-term GLP-1 receptor agonist use with an elevated risk of this condition in some patient populations

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This means the B12 component in a compounded semaglutide formulation is most likely to help patients who are deficient or at risk of deficiency, those eating very little, those following plant-based diets, older adults whose B12 absorption decreases with age, or those with conditions affecting B12 absorption like gastric bypass or certain GI conditions

J Alzheimers Dis 45:395405 Chio A, Cucatto A, Terreni AA, Schiffer D (1998) Reduced glutathione in amyotrophic lateral sclerosis: an open, crossover, randomized trial

The changes become systemic, not just cosmetic