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Deficiency of vitamin B-12 can lead to abnormal neurologic and psychiatric symptoms including ataxia (shaky movements and unsteady gait), muscle weakness, spasticity, incontinence, hypotension, vision problems, dementia, psychoses, and mood disturbances.

Some patients benefit from starting B12 supplementation at the same time they begin semaglutide therapy, while others may only need it after 36 months of GLP-1 treatment

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[DOI] [PMC free article] [PubMed] [Google Scholar] 72.Salami M

Sonic hedgehog-dependent activation of Gli2 is essential for embryonic hair follicle development

Visual inspection is a good backup, but the date of first use is the rule you must live by