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Meissner WG, Remy P, Giordana C, et al

While healthy kidneys can typically manage this, for individuals with undiagnosed or pre-existing kidney disease, this sustained strain could be harmful

You should also look into underlying GI conditions and drug interactions (such as steroids or laxatives) that could impair absorption

[36] Other disorders that can disrupt the absorption of vitamin B 12 in the small intestine include coeliac disease, surgical removal, Crohn's disease, and HIV

Closest cash-pay analog to Rybelsus or the Wegovy pill