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licensed UK options include orlistat, semaglutide (Wegovy, TA875), and liraglutide (Saxenda, TA664), all with established safety profiles
Elevated NNMT activitycommon in obesity and metabolic syndromedepletes NAD+ reserves by shunting nicotinamide into an excretory pathway rather than salvaging it for NAD+ biosynthesis
Retatrutide, the newer triple agonist, also comes in 10mg vials
These medications reduce gastric acid production, which is necessary for releasing dietary vitamin B12 from food proteins and for maintaining the stability of the B12-intrinsic factor complex
Women with low B12 may experience memory lapses, difficulty concentrating, and even increased risk of dementia as they age
Treatment should not be delayed pending test results if neurological features are present
