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Alexander KS, Wu HQ, Schwarcz R, Bruno JP

Patients with a history of severe gastrointestinal disease, particularly those with inflammatory bowel disease, severe gastroesophageal reflux disease, or history of pancreatitis, require careful evaluation before considering this therapy

Your prescriber can review the timing of the symptoms, dosage, speed of weight loss, nutritional intake, physical side effects, other medications and mental health history before deciding on the most appropriate next step

It's important to understand that you have to address all of those things, but you don't have to do it all at once

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Both intramuscular injections and sublingual supplements have been shown to effectively correct vitamin B12 levels in these patients