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Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey

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In this context, Xu et al

Storage After Reconstitution Do This Store in refrigerator at 36-46F (2-8C) Keep away from light (store in box if possible) Use within 28-60 days of reconstitution Inspect for particles before each use Always swab the stopper before drawing Never Do This Never freeze reconstituted retatrutide Don't leave at room temperature for extended periods Don't use if solution is cloudy or has particles Don't use past the expiration date Never share vials or needles Stability note: While some sources cite 60-day stability, 28 days is the more conservative recommendation for compounded peptides

[20] [21] When used together, these medications may have complementary effects on weight , though the primary therapeutic goal remains glycaemic control rather than weight reduction