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Vitamin B12 is one of the nutrients your body needs to keep your nerve and blood cells healthy

When you swallow a B12 pill, several steps have to work for it to be absorbed: stomach acid and the enzyme pepsin must release B12 from food or the supplement, the stomach must secrete a protein called intrinsic factor that binds to B12, and the B12-intrinsic factor complex must reach the ileum (the end of the small intestine) where it is finally absorbed

A second possibility is an undiagnosed autoimmune component, where pernicious anaemia is contributing to the deficiency on top of the bariatric anatomy

The combination of reduced appetite, improved metabolic signaling, and increased energy expenditure makes retatrutide fundamentally different from single-agonist peptides