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If supplements are necessary, then consider B12 injections in Richardson

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Heart rate should be monitored at regular intervals consistent with usual clinical practice in patients taking semaglutide and patients should inform health care providers of palpitations or feelings of a racing heartbeat while at rest during semaglutide treatment

Those who follow a vegetarian or vegan diet are particularly prone to vitamin B-12 deficiency, as are those with a condition known as Pernicious anemia which affects B-12 absorption in the gut