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This is certainly not a good sign

Supplementing with this is a very effective treatment for B12 deficiencies commonly found in patients who suffer from diseases or have nutritional deficits (such as ultra low calorie diets)

Severe deficiency: For severe cases, more doses or injections might be needed, even if there are neurological symptoms

Pediatric Use: Intake in children should be in the amount (0.5 to 3 mcg daily) recommended by the Food and Nutrition Board, National Academy of Science-National Research Council

Among the GLP-1 RAs, evidence of CV benefit is strongest for liraglutide, favorable for semaglutide, and less certain for exenatide