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Treatment considerations include: Concurrent folate supplementation if deficient (never give folate alone, as it may precipitate neurological deterioration) Potassium monitoring during initial treatment in severe anaemia or at-risk patients (e.g., those with heart failure) Response assessment: reticulocyte count peaks at 57 days, haemoglobin normalises within 68 weeks Neurological symptoms may take 612 months to improve and may not fully resolve Patients should be advised that treatment for pernicious anaemia or post-surgical deficiency is lifelong

Keep in mind that guidance for some medications suggests discontinuing them two months prior to conception, so patients who find out theyre unexpectedly pregnant while on weight loss medications should cease immediately and speak with their provider

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What is changing is how broadly they are being studied and how often they are discussed outside traditional regulatory and clinical frameworks (Rossino et al., 2023)