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Oral B12 requires a protein called intrinsic factor in the stomach to be absorbed properly

Typical features you might notice: Diffuse thinning across the entire scalp rather than circular bald patches A noticeable increase in hair in the shower, on your pillow, or in your brush Hair feels less dense or ponytail thinner, but your hairline may still look similar Shedding that starts 24 months after starting the medication, increasing the dose, or hitting a rapid weight-loss stretch In most cases, telogen effluvium is temporary

That triple mechanism is what produced the headline-grabbing results from the Phase 2 NEJM trial, where the 12 mg dose group achieved an average 24.2% body weight reduction over 48 weeks

It puts injection frequency preference into the same conversation as clinical history and prior medication tolerability when weighing options