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It also has a distinctive regulatory position: it was previously an FDA-approved product (marketed as Geref, a diagnostic agent) before being voluntarily withdrawn from the market, and that prior-approval history has given it a more stable standing for compounding than most other peptides

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Monitoring schedule Healthcare providers who specialize in GLP-1 therapy typically recommend this monitoring cadence: Baseline: Full B12 panel before starting semaglutide 3 months: Repeat serum B12 and MMA 6 months: Full panel reassessment Annually: Once stable, annual monitoring is usually sufficient For high-risk patients (metformin users, vegans, those over 60, post-bariatric surgery), the 3-month check is particularly important