So that when they come off of these meds, they can [00:14:00] appropriately eat well, balanced diet, 80 20, I think people should not have to do more than an 80 20, we should not have to live in a 100 percent restrictive, you know, dogmatic lifestyle, and um, can exercise and be able to maintain their weight with appropriate effort
And I realized Im like, Oh, so the years it would go, probably somewhere where you are, low to moderate temperature, then you get these spikes of sustained days that are hot would just crush me
The combination is most useful for patients with one or more of the following: BMI of 30 or higher , or BMI 27 with at least one weight-related condition such as type 2 diabetes, hypertension, or sleep apnea History of fatigue, low mood, or brain fog on previous diets or weight loss attempts Metformin use for type 2 diabetes or pre-diabetes (chronic metformin reduces B12) Long-term proton pump inhibitor use such as omeprazole, pantoprazole, or lansoprazole Vegetarian or vegan diet with limited animal protein intake Adults over 50 , where B12 absorption naturally declines Active strength training or higher physical demands while on a calorie deficit Patients who dont fit any of these profiles can still take semaglutide alone, then add B12 if symptoms suggest it
People with variants in the SLC22A5 gene (often referred to as carnitine transporter deficiency) which results in carnitine deficiency can have skeletal myopathy and/or cardiomyopathy [7]
PMID: 26277634 9 Oral vitamin B12 supplementation in pernicious anemia: a prospective cohort study
Diabetes Care 39 , 222230 (2016) L.A
