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The owner of the spa where Amma received her injections did not respond to a request for comment

While most individuals obtain sufficient amounts of vitamin B12 through their diet, some individuals may require supplementation due to certain health conditions or lifestyle choices that can lead to vitamin B12 deficiency

in 2023 conducted a double-blind, randomized, placebo-controlled trial that examined the oral administration of collagen dipeptides (1650 mg per day for 12 weeks) in 100 women in Korea (3060 years of age) and compared the placebo group ( n = 46) with the treatment group ( n = 54) in terms of skin hydration, elasticity, desquamation, and wrinkling [42]

Conservative approach (better tolerated) Slower escalation: Week 1-6: 0.6mg weekly Week 7-12: 1.2mg weekly Week 13-18: 1.8mg weekly Week 19+: 2.4mg weekly (or stay at 1.8mg) Benefits: Fewer side effects Better tolerability Good for GI-sensitive people Still effective (slightly less weight loss) Maintenance at lower dose: Some maintain at 1.8mg or 2.0mg 8-10% weight loss still achievable Better long-term sustainability More affordable Aggressive protocol (maximum weight loss) Higher doses (some trials): Week 1-4: 0.6mg weekly Week 5-8: 1.2mg weekly Week 9-12: 2.4mg weekly (faster) Week 13-16: 3.0mg weekly Week 17+: 4.5mg weekly (maximum) Warning: Higher side effect risk Nausea very common at 4.5mg Not necessary for most people Only if excellent tolerability Research setting primarily Expected additional benefit: 4.5mg: ~11-12% vs 2.4mg: ~10% Modest additional loss May not justify side effects Individualized decision Combination with semaglutide dosing CagriSema protocol: Start both simultaneously OR add cagrilintide to existing semaglutide Semaglutide: Titrate to 2.4mg over 16-20 weeks Cagrilintide: Titrate to 2.4mg over 12-16 weeks Both weekly injections (can be same day) Sequential approach (if already on semaglutide): Stable on semaglutide 2.4mg for 4+ weeks Add cagrilintide starting 0.6mg weekly Titrate cagrilintide to 2.4mg over 12 weeks Continue both Expected results: 15-25% body weight loss Superior to either alone Well-documented synergy See our cagrilintide and semaglutide , semaglutide dosage calculator , and tirzepatide dosing guide guides