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The most significant concern relates to vitamin A (retinol) content

Diabetic retinopathy complications have been observed in some patients with pre-existing retinopathy who experience rapid improvements in glycemic control with semaglutide therapy
How to Prevent and Overcome Vitamin B12 Overdose The Institute of Medicine reports that there are no adverse effects associated with excess vitamin B12 intake from food and supplements in healthy individuals

Understanding the limitations of this data helps set realistic expectations about long-term use
