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Volume awareness: With a vial, you draw the exact volume prescribed each week

However, pernicious anemia, in which the body is unable to properly absorb B12, affects some people

If your current dose is no longer producing results, several physiological factors may be at play: receptor downregulation (your body's GLP-1 receptors become less sensitive), tolerance development, changes in gut bacterial response to medication, or insufficient dosing for your specific genetic profile

The good news is that this is one of the more fixable side effects - most people find that consistent electrolyte support, whether through food, drinks or supplements, clears the cramps within a few days

Although transient elevations in liver metabolic enzymes occurred during treatment, subsequent abdominal ultrasound examinations revealed no hepatic abnormalities