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For patients specifically dealing with aod-9604 for gut health, the approach depends on your treatment phase

Long-term deficiency can damage the protective myelin around nerves, and if it is not addressed, some of that damage can become permanent, causing numbness, pain, and balance problems

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However, GLP-1 agonists like semaglutide have more established long-term safety data

How should treatment response be evaluated and monitored

The following is taken from the section, "How should treatment be given", from the peer-reviewed medical-journal article, "The Many Faces of Cobalamin (Vitamin B12) Deficiency": [Start quote] For parenteral therapy in cases of megaloblastic anemia, it has been advised to administer 1000 mg hydroxocobalamin IM twice weekly for a period of 5 weeks, and the dose is reduced to 1000 mg IM every 2 months thereafter