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Additionally, some individuals taking Mounjaro may have pre-existing conditions that independently increase their risk of B12 deficiency, such as previous bariatric surgery or concurrent metformin use (the MHRA has highlighted that metformin can reduce vitamin B12 levels)

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Glucagon-like peptide-1 receptor agonists were associated with meaningful improvement in glycemic control but conferred no short-term reduction in weight or body mass index (BMI) in patients with Prader-Willi syndrome (PWS), according to a retrospective cohort analysis from a specialist clinic presented at the Society for Endocrinology British Endocrine Societies (SfE BES) 2026 and published in Endocrine Abstracts

It includes 1-5 intramuscular or subcutaneous injections of 1000 mcg crystalline cyanocobalamin daily, followed by oral doses of 1000-2000 mcg/day Parenteral administration should be reserved for those with significant neurological symptoms NICE guideline: Vitamin B 12 deficiency in over 16s: diagnosis and management: Malabsorption as the confirmed or suspected cause of vitamin B 12 deficiency: Offer replacement to people if: lifelong intramuscular vitamin B12 Autoimmune gastritis is the cause They have had a total gastrectomy They have had a complete terminal ileal resection If the person has a vitamin B 12 deficiency because of malabsorption that is not caused by autoimmune gastritis, or a total gastrectomy or complete terminal ileal resection (for example, malabsorption caused by coeliac disease, partial gastrectomy or some forms of bariatric surgery): Offer vitamin B 12 replacement and Consider intramuscular instead of