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Human studies have shown that ALA is rapidly absorbed, with limited oral bioavailability (~30%) due to its low solubility and short blood half-life, which result from extensive first-pass hepatic metabolism and elevated systemic elimination [8,55,56,57]

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10.1007/s00228-009-0735-3 258

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If patients are eating less and potentially consuming less B12-rich food, supplementing directly alongside the semaglutide injection ensures adequate intake without requiring a separate oral supplement