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UK guidance (MHRA and NICE) advises checking B12 levels in patients on metformin who develop symptoms of deficiency (anaemia, neuropathy) and considering periodic monitoring in those on long-term therapy

Conservative titration to 8mg Not everyone needs or tolerates the full 12mg dose

This means that a peptide with a 2-hour half-life administered three times daily will reach steady-state within approximately 10 hours, while a peptide with a 7-day half-life like Semaglutide requires roughly 35 days to reach steady state with weekly dosing

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