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The FDA-approved prescribing information for semaglutide does not list thrombotic events or venous thromboembolism (VTE) as recognized adverse effects of the medication

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However, B12 levels can rise regardless of whether treatment is effective

Some Sources of Vitamin B12 Vitamin B12 occurs naturally in many everyday foods, such as: Meat Fish Dairy Eggs Some fortified cereals Why Are Three B Vitamins Better Than One

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Nicotinamide (niacinamide) does not cause flushing and has fewer side effects, with nausea and liver toxicity reported only at very high intakes ~3 g/day)