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Unexplained anemia: Particularly in a specific form (megaloblastic anemia) where the red blood cells are enlarged, a vitamin B12 deficiency is a common cause

Oral B12 is broken down by stomach acid before it absorbs

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As with all GLP-1 agonists, long-term post-marketing surveillance will be essential to characterize the pancreatic safety profile with greater statistical precision, particularly for rare events such as acute pancreatitis (estimated background rate of approximately 35 per 100,000 person-years in the general population) and the theoretical concern about pancreatic cancer