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Semaglutide does not directly affect intrinsic factor production, but the reduced stomach acid environment can compromise the initial separation step that makes b12 available for intrinsic factor binding

Individuals with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia type 2 (MEN2) should discuss this with their clinician before considering any GLP-1based therapy, and should be alert to symptoms such as a neck lump, hoarseness, or difficulty swallowing

This mechanism has particular relevance for athletes whose growth hormone levels fluctuate with training stress and recovery status

Oral supplements, on the other hand, may not be as effective for individuals with digestive issues

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