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Other populations at risk include people who had gastrointestinal surgery (including weight loss surgery) and diseases that affect the gut, such as Crohn's disease or celiac disease

Herbal preparations that affect blood glucose levels, such as ginseng, fenugreek, or bitter melon, may have additive glucose-lowering effects when combined with semaglutide, potentially increasing the risk of hypoglycemia particularly in patients receiving other antidiabetic medications

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In addition, the bioavailability of the vitamin B12 ingested depends on the amount delivered in each dose (Domke et al., 2004)