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In preclinical models this combination showed an additive effect

"Effect of Vitamin B6, B9, and B12 Supplementation on Homocysteine Level and Cardiovascular Outcomes in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials"

Warren et al., 2024)

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High-yield reporting fields for suspected semaglutide-related vaginal symptoms include: dose and escalation dates, concomitant SGLT2 inhibitor use, antibiotic/antifungal use, menopausal status/HRT, diabetes control markers, symptom description with onset/offset, objective test results (pH, microscopy/NAAT), and dechallenge/rechallenge outcomes if they occur