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The following adverse effects were reported in patients receiving semaglutide injection or oral tablets across all clinical trials and at incidences higher than with placebo: nausea (11% to 44%), vomiting (5% to 24%), diarrhea (8.5% to 30%), abdominal pain (5.7% to 20%), abdominal distention (2% to 7%), constipation (3.1% to 24%), dyspepsia (0.6% to 9%), decreased appetite (6% to 9%), eructation (0.6% to 7%), flatulence (0.4% to 6%), gastroesophageal reflux disease (1.5% to 5%), gastroenteritis (4% to 6%), and gastritis (0.4% to 4%)

Without that I find the injections virtually pain free

Vitamin B12 (cobalamin) is a water-soluble vitamin that plays essential roles in red blood cell formation, cell metabolism, nerve function and the production of DNA

"The adolescent and adult form of cobalamin C disease: clinical and molecular spectrum"

Some people dont produce enough intrinsic factors, and they also can become deficient