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One very small study found that people who used semaglutide had lower B12 levels, but these patients also had bariatric surgery prior to using semaglutideso its hard to say if using semaglutide would lead to a B12 deficiency, requiring additional B12

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Extended half-life and prolonged receptor engagement: One of the defining features of IGF-1 LR3 is its structural modification that reduces binding to IGF-binding proteins

SHIRLEY, NY 11967 Carton CYANOCOBALAMIN INJECTION, USP 10,000 mcg/10 mL (1,000 mcg/mL) NDC 0517-0032-25 25 x 10 mL MULTIPLE DOSE VIALS FOR INTRAMUSCULAR OR SUBCUTANEOUS USE ONLY Rx Only Each mL contains: Cyanocobalamin 1000 mcg, Benzyl Alcohol 1.5%, Sodium Chloride 0.9%, Water for Injection q.s