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While this is completely normal, a prolonged plateau could be a sign that the medication isnt working as it should

Risk-Benefit Analysis Potential Benefits: Reduced nausea and GI side effects More stable appetite control Personalized dose optimization Gradual adaptation possible Theoretical efficacy maintenance Known Risks: No clinical safety data Unknown long-term effects Injection burden and errors Potential reduced efficacy Insurance/cost complications The Bottom Line The PK math behind microdosing reta is sound

Self-administered B12 shots are generally recommended for individuals: whose bloodwork has documented low B12 levels Patients with pernicious anemia or a lack of intrinsic factor Individuals with Crohn's disease, celiac disease, or post-bariatric surgery malabsorption Vegans and strict vegetarians are unable to correct the deficiency through diet Older adults whose stomach acid production has declined with age Anyone on long-term metformin or proton pump inhibitors Across most of the U.S., injectable B12 is not sold over the counter a clinician has to write the script before a pharmacy can dispense it

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However it is possible that a rapid increase in blood glucose levels (after treating hypoglycaemia), may trigger a further episode of reactive hypoglycaemia in post bariatric patients