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This is also the case for those with exocrine pancreatic insufficiency (EPI)

B12 supplements may improve heart health by reducing homocysteine levels, a compound that is associated with an increased risk of heart disease

The mechanism underlying these opposing gastrointestinal effects likely relates to semaglutides complex effects on gastrointestinal motility, with some patients experiencing accelerated intestinal transit while others experience overall slowing of gastrointestinal motility