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Most obesity medicine specialists recommend sequential monotherapy or waiting for robust clinical trial data before endorsing dual use

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People with malabsorption or gastrointestinal disease Conditions such as pernicious anemia, post-gastric surgery states, celiac disease, long-term proton pump inhibitor use, or other malabsorption syndromes reduce absorption of B12 from food and pills

As pregnant women are typically excluded from clinical trials, their safety for the developing fetus is unknown