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It is important to note that a direct, well-established causal link between GLP-1 receptor agonist use and clinically significant B12 deficiency has not been confirmed in the published literature

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(11) I I Mikhaleva, V T Ivanov, L V Onoprienko, et al (2014) Antioxidant and detoxifying activities of analogues of the delta sleep inducing peptide Russian Journal of Bioorganic Chemistry, 29 January 2014, Volume 40, pages 18

Key safety considerations include pre-treatment endocrine baseline assessment, monitoring of serum IGF-1 within physiological reference ranges, evaluation of glucose metabolism and insulin sensitivity, and awareness of potential fluid retention

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