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You are sitting in your doctors office, desperately trying to explain the profound, unyielding exhaustion that has taken over your life since your viral infection

For individuals with BMI above 30 or BMI above 27 with comorbidities, FDA-approved GLP-1 receptor agonists (semaglutide, tirzepatide) have far stronger evidence and produce dramatically greater weight loss

However, the body is generally very efficient at excreting excess B12 through urine without any issues

[10] Initial assessment involves: Detailed medical history, including dietary habits and gastrointestinal symptoms Medication review (certain drugs like metformin and proton pump inhibitors can affect B12 absorption) [20] [21] Family history of pernicious anaemia or autoimmune conditions Physical examination for signs of anaemia or neurological abnormalities Laboratory investigations typically include: Serum vitamin B12 level: The primary test, though interpretation can be complex