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B12 is safe on its own, but a few conditions call for extra care, which is why a provider reviews your history before treatment: Leber's hereditary optic neuropathy, a rare inherited eye condition, where certain forms of B12 may be a concern for the optic nerve

Monitoring schedule Healthcare providers who specialize in GLP-1 therapy typically recommend this monitoring cadence: Baseline: Full B12 panel before starting semaglutide 3 months: Repeat serum B12 and MMA 6 months: Full panel reassessment Annually: Once stable, annual monitoring is usually sufficient For high-risk patients (metformin users, vegans, those over 60, post-bariatric surgery), the 3-month check is particularly important

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