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In practical terms you may benefit from a broad spectrum multivitamin and mineral supplement, plus extra folate and maybe potassium, magnesium, iron and vitamin D, ideally from your diet

Effect of Incretin-Based Therapies on Blood Pressure: A Systematic Review and Meta-Analysis

Conditions associated with elevated B12 levels include: Liver disease : Hepatocellular damage releases stored B12 into circulation, with levels correlating with disease severity in conditions such as cirrhosis, hepatitis, and hepatocellular carcinoma Renal impairment : Reduced kidney function decreases B12 clearance, leading to accumulation Haematological malignancies : Myeloproliferative disorders, acute leukaemia, and polycythaemia vera can elevate B12 through increased production of B12-binding proteins (transcobalamins) Solid tumours : Certain cancers, particularly those affecting the liver or gastrointestinal tract, may elevate B12 levels A specific concern relates to cyanocobalamin in patients with Leber's hereditary optic neuropathy , a rare mitochondrial disorder

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A reasonable candidate is someone who: Is already following a structured, clinician-supervised nutrition and activity plan Has a documented B12 deficiency or a condition that impairs B12 absorption Cannot tolerate GLP-1 medications, or is not a candidate for them Declines prescription pharmacotherapy and wants a non-stimulant, non-surgical adjunct Understands because the clinician has said so plainly that the injection is a supporting player A poor candidate is someone who wants the shot instead of the program