Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options. oral vitamin B12 is an effective alternative to vitamin B12 IM injections Cochrane Review
In the second subgroup (ALC add-on vs the same background drug), Gavrilova et al 19 observed AEs in 35% with ALC add-on versus 45% with antidepressant alone, and Ramezani et al 20 reported AEs in three patients (1 in ALC + sertraline, 2 in sertraline + placebo)
Our guides to heartburn on tirzepatide and semaglutide acid reflux cover management options including dietary adjustments and positioning strategies

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She says the typical dose to meet these levels is 4000 IU per day