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Specific situations requiring medical review include: Severe or persistent gastrointestinal side effects from Mounjaro that significantly limit your food intake for more than a few days You are taking metformin in addition to Mounjaro, as this combination increases B12 deficiency risk You have a history of pernicious anaemia, gastric surgery, or conditions affecting nutrient absorption You are considering stopping B12 injections whilst taking Mounjaro You experience any unexplained neurological symptoms Urgent medical attention is needed if you develop severe, persistent abdominal pain (which may radiate to the back), persistent vomiting, fever, or yellowing of the skin/eyes, as these could indicate pancreatitis or gallbladder problems Your GP or practice nurse can arrange blood tests to check your B12 levels (serum B12, holotranscobalamin, and if borderline, methylmalonic acid levels may be used where available) and determine the appropriate frequency of B12 injections if deficiency is confirmed

Lilly has experimented with direct-to-consumer pricing through its own LillyDirect channel, and Novo has signaled interest in similar approaches for Wegovy

Both groups were followed for an additional 52 weeks

For many patients, hormones and metabolism make results harder to achieve

The international classification of cell death modalities includes apoptotic and nonapoptotic processes, including necrotic apoptosis, pyroptosis, and ferroptosis