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TRIUMPH-4 is the first pivotal trial to confirm that the weight-loss signal seen in Phase 2 scales with longer exposure and higher doses, and it adds several new secondary findings that reshape how researchers think about 9 mg and 12 mg as working doses

Elevated serum B12 levels discovered incidentally on blood tests are often asymptomatic

Babula, P., et al

The choice between medications should rest primarily on efficacy data, tolerability, availability, and cost rather than the B12 inclusion, which is valuable in both formulations

[1] [2] This complex absorption mechanism means that deficiency can arise not only from inadequate dietary intake but also from malabsorption disorders

I started out with a similar level (after a holiday in the south of France) but with a year plus of taking 2000iu d3 with 90mcg k2 daily it reached over 90