Unlock Rapid Weight Loss: The Surprising Benefits and Risks of Semaglutide and B12 You Need to Know!

Obesity is a significant public health concern, with rising prevalence rates globally. The World Obesity Atlas 2023 highlights the increasing challenges posed by obesity. Being overweight or obese can take a toll on both physical and mental health. For some people with underlying medical conditions, including diabetes or imbalanced hormones, no matter how much exercise they do or how much junk they cut out of their diet, they can’t seem to lose weight. If this sounds like you, adding a doctor-prescribed medication to your routine may help you with your weight loss journey. One medication for weight loss is semaglutide with B12. This combination has been shown to help reduce cravings, reduce appetite, and improve glycemic control. Semaglutide, a GLP-1 receptor agonist, has emerged as an effective medication for weight loss and type 2 diabetes management. Cyanocobalamin, a form of vitamin B12, is often combined with semaglutide in compounded formulations. This article explores the use of semaglutide and cyanocobalamin for weight loss, examining their mechanisms of action, potential benefits, side effects, and important considerations.

Understanding Semaglutide

Semaglutide is a medication designed to mimic the glucagon-like peptide-1 (GLP-1) hormone that naturally occurs in your body. GLP-1 is made in the intestinal tract in response to the food you eat. Every time you eat, your body releases this hormone. Its job is to help regulate blood sugar and control the liver’s glucose production. If you have type 2 diabetes, your body struggles to regulate insulin levels, which is why semaglutide is an active ingredient in many type 2 diabetes medications. Semaglutide is the active ingredient in medications like Ozempic and Rybelsus, primarily used to manage type 2 diabetes and obesity. Some common semaglutide brand names include Wegovy and Ozempic. It belongs to a class of medications called incretin mimetics.

How Semaglutide Works

Semaglutide works by mimicking GLP-1, a hormone that helps control blood sugar levels by causing the pancreas to release insulin, decreasing the production of glucagon, and slowing down the emptying of the stomach. Semaglutide stimulates insulin production and reduces glucose production, helping to lower blood sugar levels. While semaglutide’s primary function is to regulate blood sugar levels, it also causes slowed gastric emptying. Gastric emptying is the process of food leaving your stomach through the duodenum. Slower gastric emptying means your body will not feel hungry as often. This change in gastric emptying is how semaglutide helps decrease appetite and encourage weight loss.

Semaglutide for Weight Loss: Clinical Evidence

Semaglutide has demonstrated significant weight loss benefits in clinical trials. In one study, the use of semaglutide over 104 weeks showed significant weight loss benefits for people with obesity or overweight and related health challenges. Those on semaglutide lost an average of 15.2% of their body weight, compared to 2.6% in the placebo group.

The Role of Cyanocobalamin (Vitamin B12)

Cyanocobalamin is a form of vitamin B12 that plays a crucial role in your body’s metabolism, energy production, and nervous system function. Vitamin B12 is essential for various bodily functions, including nerve function, DNA synthesis, and red blood cell formation. It helps manage the fatigue often experienced with semaglutide therapy, leading to enhanced energy levels and improved well-being. B12 helps improve markers of heart health, potentially reducing the risk of heart-related complications in people with type 2 diabetes.

Read also: Transformations with Ozempic

Why Combine Semaglutide with Vitamin B12?

Taking compounded semaglutide and vitamin B12 may enhance its effects, as B12 helps maintain energy levels and supports nervous system health. The combination of semaglutide and cyanocobalamin is particularly beneficial for individuals with obesity-related vitamin B12 deficiencies. Semaglutide tackles appetite suppression and glucose regulation while cyanocobalamin supports healthy metabolism and energy levels.

Theoretical Benefits

Preventing B12 Deficiency: All GLP-1 receptor agonist drugs, like semaglutide, slow down gastric emptying and reduce stomach acid production. This means they could affect the absorption of vitamin B12, which can potentially lead to vitamin B12 deficiency or worsen it in someone who already has it. Vitamin B12 is absorbed in the stomach with the help of stomach acid and intrinsic factor, a protein produced by the stomach. In theory, receiving a compounded semaglutide and B12 injection may help prevent vitamin B12 deficiency.
Enhancing Therapeutic Effects: Studies show that Vitamin B12 plays an important role in fat metabolism. Semaglutide and Vitamin B12 together can help improve your metabolism and improve your weight loss success. In theory, receiving a compounded semaglutide and B12 injection could potentially enhance the medication’s therapeutic effects.

Is There Scientific Evidence?

There’s limited scientific evidence directly linking semaglutide use to vitamin B12 deficiency or recommending routine vitamin B12 supplementation for people taking semaglutide. However, some healthcare professionals may recommend the combination because of theoretical considerations. More research is needed to confirm the effects of compounded semaglutide with vitamin B12 for weight loss.

Administration and Dosage

A semaglutide and B12 compounded injection is typically administered as semaglutide without B12 vitamin. It is a subcutaneous shot, meaning it’s injected under the skin. Semaglutide is typically administered as a once-weekly injection under the guidance of a healthcare provider. Cyanocobalamin can be taken orally or injected, depending on your specific requirements.

Injection Information

Injection site: The injection is usually given in the abdomen, thigh, or upper arm. A healthcare professional will show you how to properly administer the injection or will do it for you. Ensure to administer medication in a different body area each time.
Frequency: Semaglutide with B12 is usually injected once a week.
Dosage: You typically start with a 0.25 mg dose of semaglutide and B12, and your doctor may adjust the dose to 0.5 mg based on your needs. Once-weekly semaglutide/cyanocobalamin is injected subcutaneously starting at 0.25 mg/0.125 mg and titrated to a maximum dose of 2.4 mg/0.24 mg.

Expected Weight Loss with Semaglutide and B12

In a study of 175 participants with overweight or obesity, those taking semaglutide lost 5.9% of their body weight at 3 months and 10.9% at 6 months. For someone weighing 200 pounds, this would be around 11-21 pounds at 3 months and 20-39 pounds at 6 months. Combining it with B12 might enhance these effects.

Additional Benefits

Improved Blood Sugar Management: Semaglutide stimulates insulin production and reduces glucose production, helping to lower blood sugar levels. B12 may further support this process by promoting the proper functioning of insulin-producing cells in the pancreas.
Increased Energy Levels: B12 helps manage the fatigue often experienced with semaglutide therapy, leading to enhanced energy levels and improved well-being.
Support for Cardiovascular Health: B12 helps improve markers of heart health, potentially reducing the risk of heart-related complications in people with type 2 diabetes.
Management of Side Effects: Though side effects of semaglutide are typically mild, including nausea and diarrhea, B12 is being studied as a potential strategy to lessen these effects when compounded with semaglutide.

Real-World Outcomes: A Retrospective Study

A retrospective study included individuals who participated in a weight management programme at a commercial wellness studio receiving once-weekly compounded semaglutide/cyanocobalamin injections from June 2023 to January 2024.

Key Findings

Participants: A total of 94 individuals were analysed (81F/13M), age in years mean (SD) = 46.57 (10.60).
Weight Loss: After 3 months, average weight loss was 4.11 (2.77) kg or 4.57% (2.96%).
Body Composition: Individuals lost fat mass (2.67 (2.37) kg) and trunk fat mass (1.10 (1.36) kg), while also losing small amounts of lean mass (1.43 (1.41) kg) and skeletal muscle mass (0.88 (0.81) kg).

Implications

This study demonstrates that meaningful weight loss is achievable on semaglutide/cyanocobalamin outside of a closely controlled environment.

Potential Side Effects and Risks

Semaglutide may lead to gastrointestinal problems, such as nausea, diarrhea, or constipation. These side effects are usually mild and tend to improve over time. In addition, some people may experience increased hunger if they miss a dose of semaglutide. The semaglutide with B12 for weight loss side effects are usually mild. The most common experienced side effects include:

Dizziness
Headache
Fatigue
Nausea
Vomiting
Stomach pain
Diarrhea
Constipation

To combat these side effects, many family doctors in Riverview start their patients on a low dose of semaglutide and gradually increase the dose to let their patients’ bodies adjust.

Important Warnings and Precautions

Thyroid Cancer Risk: Semaglutide injection caused thyroid tumors in rats. It is not known if this medication increases the risk of tumors in humans. Tell your doctor if you or anyone in your family has or has ever had thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2; condition that causes tumors in more than one gland in the body). If so, your doctor will probably tell you not to use semaglutide injection. If you experience any of the following symptoms, call your doctor immediately: a lump or swelling in the neck; hoarseness; difficulty swallowing; or shortness of breath.
Other Health Conditions: Tell your healthcare provider if you have pancreas or kidney problems, type 2 diabetes, diabetic retinopathy, take other medications to treat type 2 diabetes such as sulfonylureas or insulin, have mental health issues including depression or suicidal thoughts.
Pregnancy: Do not take if you are pregnant or planning on becoming pregnant as this product may harm your unborn baby. Stop using this product at least 2 months before you plan to become pregnant. It is unknown if semaglutide passes into your breastmilk.
Allergies: Do not take this medication if you are allergic to any components of this product.
Medication Interactions: Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Serious Side Effects

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

Harming or killing yourself
Rash; itching; fainting or dizziness; swelling of the eyes, face, mouth, tongue, or throat; or difficulty breathing or swallowing
Decreased urination; or swelling of legs, ankles, or feet
Vision changes
Pain in upper stomach; yellowing of skin or eyes; fever; or clay-colored stools
Rapid or pounding heartbeat
Severe stomach problems

General Guidance

Keep all appointments with your doctor and the laboratory. Your doctor may order certain tests to check your body's response to semaglutide injection.
You will be given the Medication Guide when you begin treatment with semaglutide injection and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions.
Use semaglutide injection exactly as directed. Your doctor may increase your dose again after another 4 weeks based on your body's response to the medication.
Semaglutide injection helps to control diabetes and weight loss, but does not cure it. Continue to use semaglutide injection even if you feel well. Do not stop using semaglutide injection without talking to your doctor.
Always look at the semaglutide solution before you inject it. It should be clear, colorless, and free of particles. Do not use semaglutide if it is colored, cloudy, thickened, or contains solid particles, or if the expiration date on the pen has passed.
Never reuse needles and never share needles or pens. Always remove the needle right after you inject your dose. Dispose of needles in a puncture-resistant container. Use a different site for each injection.
Inject the missed dose as soon as you remember it within 5 days after the missed dose. However, if more than 5 days have passed, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Compounded Semaglutide: FDA Concerns

Compounded semaglutide with vitamin B12 is available in the market but has not been approved by the Food and Drug Administration (FDA). The FDA has raised concerns about compounded versions of semaglutide and tirzepatide.

Read also: Semaglutide Without Diet Changes

Risks of Compounded Drugs

A compounded drug might be appropriate if a patient’s medical need cannot be met by an FDA-approved drug, or the FDA-approved drug is not commercially available. However, compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed. The agency has identified some areas of concern for compounded GLP-1 drugs.

Specific Concerns

Improper Storage: Injectable GLP-1 drugs require refrigeration as indicated in their package inserts. FDA has received complaints that certain compounded GLP-1 drugs have arrived warm or with inadequate ice packs to keep the drug at recommended storage temperatures.
Counterfeit Products: FDA is aware of compounded semaglutide products that contain false information on the product label. In some cases, the compounding pharmacies identified on the labels of the products do not exist. In other cases, the labels of the fraudulent compounded medicine contain the name of a licensed pharmacy that, based on information FDA has gathered, did not compound these products.
Dosing Errors: FDA received multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products. These dosing errors resulted from patients measuring and self-administering incorrect doses of the drug, and in some cases, health care professionals miscalculating doses of the drug.
Unapproved Ingredients: The agency is aware that some semaglutide products sold by compounders may be the salt forms. These salt forms, including semaglutide sodium and semaglutide acetate, are different active ingredients than are used in the approved drugs. The agency does not have information on whether these salts have the same chemical and pharmacologic properties as the active ingredient in the approved drug, and we are not aware of any lawful basis for their use in compounding.
Illegal Online Sales: FDA monitors the internet for fraudulent or unapproved drugs and has issued warning letters to stop the distribution of illegally marketed semaglutide and tirzepatide.

FDA Recommendations

Compounded drugs should only be used in patients whose medical needs cannot be met by an FDA-approved drug.
Patients should obtain a prescription from their doctor and fill the prescription at a state-licensed pharmacy.
Carefully check labels of compounded GLP-1 drugs for warning signs such as spelling errors or incorrect addresses and ensure your medicine is provided by a licensed pharmacy and prescribed by a licensed health care provider.
Talk to your doctor if you have questions about your medicines.

Lifestyle Changes

While semaglutide and cyanocobalamin can be powerful tools for weight loss, they work best when combined with lifestyle changes. For the fastest results, make sure you are consistently taking your medication. You should also pair your semaglutide medication with a healthy diet and routine exercise. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian.

Alternative Weight Loss Treatments

When considering weight loss options, it’s important to understand how semaglutide/cyanocobalamin compares to other treatments. Non-pharmacological options such as bariatric surgery and lifestyle interventions alone can also lead to weight loss. Ultimately, the best treatment choice depends on your individual health status, goals, and preferences.

How Long Does It Take to See Results?

Because each person has a different body chemistry, the time it takes to see weight loss results after starting semaglutide will be different for each person. Generally, patients start seeing results after 8-12 weeks.

Seeking Professional Guidance

If you are ready to make a change to your lifestyle, keep reading to learn more about semaglutide. It is advisable to consult with a healthcare professional to determine if vitamin B12 supplementation is needed based on your needs and risk factors. Before starting semaglutide/cyanocobalamin treatment, it’s crucial to have medical supervision and a personalized plan. You should talk to your primary doctor in Riverview to determine which medication is right for you. At Noorani Medical Center, we understand how difficult it can be to lose weight, which is why we offer a special medical weight loss program.

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