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Why it's the gold standard for 60+: improves absorption for adults over 60 who have reduced stomach acid or impaired intrinsic factor

Semaglutide works via central appetite suppression, gastric emptying delay, and glucose-dependent insulin secretion

as for patients with neurological improvement, 1 mg IM OH-Cbl on alternate days until there is no clinical improvement and then maintenance 1 mg IM OH-Cbl every 2 months is recommended (NICE, 2022)