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More binding protein means more B12 is held in the blood, pushing serum levels up

Receptor desensitization : Over time, GLP1 receptors may become less responsive to consistent drug exposure, reducing the appetite-suppressing effect

Hettwer J, Hinterdobler J, Miritsch B, Deutsch MA, Li X, Mauersberger C, Moggio A, Braster Q, Gram H, Robertson A, Cooper MA, Gro O, Krane M, Weber C, Koenig W, Soehnlein O, Adamstein NH, Ridker P, Schunkert H, Libby P, Kessler T, Sager HB

Some individuals notice improved energy and focus within a few days

Why Metformin Can Leave You Too Tired to Lose Weight If youve been on metformin for years, for insulin resistance, PCOS, or type 2 diabetes, and youre too drained to walk after dinner, cook at home, or stick with any weight-loss plan, a low vitamin B12 level could be part of why

Week 12: Repeat week-4 labs plus CBC with differential