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Ozempic and Wegovy accounted for 23 of the cases, with Mounjaro accounting for 10 and Saxenda for three

Methylmalonic acid is a more sensitive marker of functional B12 status Complete blood count (CBC): Establishes baseline red blood cell parameters for monitoring anemia development Iron panel (ferritin, serum iron, TIBC): Ferritin below 30 ng/mL suggests depleted stores even with normal hemoglobin Comprehensive metabolic panel: Includes calcium, magnesium (though serum magnesium is imperfect), and kidney function RBC magnesium: More accurate than serum magnesium

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Vitamin B Complex (B1, B2, B3, B5, B6, B12) - described in the brand's materials as a supporting ingredient rather than a primary active

All patients should carry a Steroid Emergency Card and have an emergency hydrocortisone injection kit with education on its use