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Image 2: Vitamin B12 absorption and metabolism Image: Simplified vitamin B12 absorption and metabolism and inter-relationship with the folate cycle

Seek immediate medical attention if cravings occur alongside : Symptoms of hypoglycemia (trembling, sweating, confusion, rapid heartbeat, dizziness) Severe nausea, vomiting, or abdominal pain Severe upper abdominal pain radiating to the back (possible pancreatitisstop medication immediately) Right upper quadrant abdominal pain, fever, or yellowing of skin/eyes (possible gallbladder disease) Discuss at scheduled follow-up appointments : Persistent, intense cravings that interfere with daily functioning Unexplained weight gain or inability to lose weight despite medication adherence Symptoms of depression, anxiety, or disordered eating patterns Questions about medication dosage or administration Healthcare providers can assess whether medication dosage adjustments are appropriate, evaluate for potential hypoglycemia, and screen for underlying conditions that may contribute to cravings, such as insulin resistance or thyroid disorders