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Some of the most common causes of vitamin B12 malabsorption are: Leaky gut and inflammatory bowel disease Gut dysbiosis (imbalance in gut bacteria) Low stomach acid (hypochlorhydria) The auto immune condition pernicious anaemia - as the body attacks and destroys intrinsic factor, the protein that is essential for B12 absorption Acid suppressant medications Excessive alcohol Vegan or vegetarian diets (plant sources are poorly absorbed) According to various studies 50% of long-term vegetarians and 80% of vegans are extremely low in B12

Semaglutide does not directly cause sleepiness in most people

For the Wegovy pill, the doses are 1.5 mg, 4 mg, 9 mg, and 25 mg

doi: 10.1016/j.nutres.2015.03.004

There have been postmarketing reports of serious hypersensitivity reactions in patients treated with sitagliptin, one of the components of JANUMET XR