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This is a novel, investigational tri-agonist peptide that acts on the GIP, GLP-1, and glucagon receptors

Christiansen CB, Gabe MBN, Svendsen B, Dragsted LO, Rosenkilde MM, Holst JJ

Neurological manifestations are particularly concerning and may include peripheral neuropathy with paresthesias (tingling and numbness in hands and feet), ataxia, impaired proprioception and vibratory sense, cognitive impairment, memory loss, and in severe cases, subacute combined degeneration of the spinal cord

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Other drugs found to inhibit vitamin B 12 absorption from food include cholestyramine (a bile acid-binding resin used in the treatment of high cholesterol), chloramphenicol and neomycin (antibiotics), and colchicine (medicine for gout treatment)