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Alcohol might increase GGT production by inducing hepatic microsomal production, or it might cause the leakage of GGT from hepatocytes

Thus, in my clinical practice, given the uncertainty about B12 blood levels, if a patient has symptoms suggestive of B12 levels affecting cellular function, unless he/she wishes to undertake further testing with homocysteine and MMA, a trial of sublingual B12 in the active form at 1-2000 mcg daily (to avoid malabsorption issues) is a reasonable course of action

This timeline mirrors the general pattern seen with other weight loss peptides

CD003498

Human data remain limited to case reports, so efficacy in clinical practice is still under evaluation