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A more accurate assessment uses methylmalonic acid (MMA) and homocysteine levels alongside serum B12

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doi:10.2353/ajpath.2008.070429 Dinic S, Arambasic J, Mihailovic M, Uskokovic A, Grdovic N, Markovic J, Karadzic B, Poznanovic G, Vidakovic M (2013) Decreased O-GlcNAcylation of the key proteins in kinase and redox signalling pathways is a novel mechanism of the beneficial effect of alpha-lipoic acid in diabetic liver

A longer-acting compound like Retatrutide works differently, acting on multiple appetite and metabolic receptors at once rather than on the Growth Hormone axis