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The strongest evidence for meaningful, long-term weight loss and cardiometabolic benefit is at the labeled maintenance doses reached using a slow, individualized titration

That means: Hypokalemia can develop or worsen which can lead to: Cardiac arrhythmias Muscle weakness QT prolongation In severe cases, sudden cardiovascular instability This is a classic board-style pearl that many clinicians forget because B12 feels benign. But in profoundly deficient patientsespecially those with severe megaloblastic anemiarepletion is metabolically active treatment

Adding an oil dressing can help to optimise absorption

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