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Common B12 deficiency symptoms include fatigue, anxiety, depression, poor memory, confusion, brain fog, tingling or numbness in the extremities, zings or zapping feelings in the extremities, anemia, shortness of breath, muscle weakness, irritability, tender calves, pale complexion and more

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Important contraindications include personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN2), history of pancreatitis, severe gastrointestinal disease including gastroparesis, and pregnancy or planned pregnancy (these medications should be discontinued at least 2 months before a planned pregnancy)