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Crucially, this happens without IGF-1 stimulation

In the UK, the most common cause of vitamin B12 deficiency is pernicious anaemia

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Patients should receive comprehensive education regarding signs and symptoms that could indicate malignancy and should be counseled to report any new symptoms or changes promptly

What is Tirzepatide

Transitioning from weight loss to maintenance Determining goal weight achievement: Lost 10-12% body weight (cagrilintide alone) Lost 15-25% body weight (CagriSema) Weight stable for 4-8 weeks Satisfied with current weight Ready to focus on maintenance Maintenance dose options comparison: Option 1: Continue same dose Keep cagrilintide at 2.4mg weekly Ensures no regain Most conservative approach Highest cost Option 2: Reduce dose slightly Decrease to 1.8-2.0mg weekly Monitor weight for 4 weeks If stable, maintain If gaining, increase back 20-25% cost savings Option 3: Try every 10 days Instead of weekly, inject every 10 days Effectively 30% dose reduction Some maintain weight this way Requires close monitoring Recommendation: Try Option 2 first (reduce to 1.8-2.0mg)