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Individuals who have had gastric bypass surgery are also at risk due to alterations to the GI tract that impair the release and absorption of B12
[1] A common starting regimen in adults with normal renal and hepatic function is 1 mL intramuscularly once or twice weekly, titrated every four weeks according to biochemical markers such as fasting lipid panel, liver transaminases, and serum carnitine
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In the withdrawal cohort, regaining half of the lost weight raised insulin resistance by roughly 35% to 40%, and blood pressure rose as weight returned. Taper frameworks combine at least 1.2 g/kg of protein with resistance training before the drug signal fades
