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The lack of vitamin B12 may result from any of the following conditions: Addisonian (pernicious) anemia this condition causes autoantibody formation against parietal cells, which results in a lack of IF essential for absorption of vitamin B12 from the intestine Malabsorption impaired absorption of vitamin B12 Gastrointestinal pathology, dysfunction, or surgery these include atrophic gastritis, celiac disease, small bowel bacterial overgrowth, pancreatic insufficiency, Helicobacter pylori infection, gastric carcinoma, and total or partial gastrectomy Diphyllobothrium latum and related species (the fish tapeworm) infestation these parasites compete with vitamin B12 for intestinal absorption

Medicare will only cover GLP-1 receptor agonists for weight loss if there is a risk of heart disease, in addition to meeting the FDA weight requirements for prescription

A manageable component of these costs is site of care for specialty drugs, which are often administered in high-cost hospital settings

Risks to Watch : Dehydration, hypoglycemia (when combined with insulin), and interactions with other medications