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B12 supplementation addresses a common deficiency seen in both ketogenic dieters and GLP-1 users

Indicators of Nutritional Deficiency Persistent fatigue accompanied by pale skin, shortness of breath, cold intolerance, hair loss, or cognitive difficulties may suggest anemia or other nutritional deficiencies requiring laboratory investigation and supplementation

So, finding the right balance is very important

If you are four weeks in with no weight loss , that does not necessarily mean the medication is not working

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10.1007/s00125-016-4199-6 12 GandhiK.TofaniC.SokachC.PatelD.KastenbergD.DaskalakisC