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These include: Opiates/narcotics Antispasmodics Tricyclic antidepressants Anti-diarrheal medications like Alosetron, Lomotil and Imodium Proton pump inhibitors Cholestyramine Preventing methane SIBO relapse As discussed above, methane SIBO is generally less susceptible to relapse than hydrogen-dominant SIBO in our experience

Botond, et al

Gastrointestinal upset and transient anxiety have also been documented in clinical observation

They may notice no difference between semaglutide alone and semaglutide with B12, because there was no deficiency to correct

You should start to see improvements within a few days to a week, however if you do not feel the effects after 2-3 injection sessions, then it is likely that you were and are not deficient in B12