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So knowing what's in the bloodstream is only indicating how much B12 has not been absorbed or used by the body yet

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For adults, the cutoff for serum holoTC, based on the relation of holoTC to serum methylmalonic acid, is 12 mol/L), the association of total serum B12 levels with serum MMA (and tHcy) was explored with restricted cubic splines (Figure 22b.5)

No thyroid C-cell tumors were observed in human trial participants, though this risk carries a theoretical basis from rodent studies and is listed as a precaution, as it is with all GLP-1 class compounds