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According to the NIH Office of Dietary Supplements, vitamin B12 is available as cyanocobalamin and hydroxocobalamin, which are typically administered parenterally by intramuscular injection to bypass gastrointestinal absorption barriers

The protection is substantial

Front Med (Lausanne) 7:536

If you are prescribed a GLP-1 medication and exhibit any of the following symptoms, you should contact your provider immediately: A lump or swelling in the neck Hoarseness Difficulty swallowing Shortness of breath Severe abdominal pain Before taking GLP-1 medications, you should also discuss the following with your provider: Allergies : Inform your doctor and pharmacist of any allergies you have to semaglutide (including under brand names Ozempic, Rybelsus, Wegovy) or similar medications such as tirzepatide (Mounjaro, Zepbound), dulaglutide (Trulicity), exenatide (Bydureon BCise, Byetta), liraglutide (Saxenda, Victoza, or in Xultophy) and lixisenatide (Adlyxin, or in Soliqua)

The findings indicate that microbial metabolite 4-ethylphenyl sulfate (4EPS) enters the brain and is associated with changes in region-specific activity and functional connectivity, including altered oligodendrocyte function, impaired oligodendrocyte maturation, and decreased oligodendrocyte-neuron interactions (Needham et al., 2022)