Three randomized withdrawal trials (SURMOUNT-4, STEP 1 extension, STEP 4) and a new BMJ 2026 systematic review of 37 RCTs and nearly 10,000 adults all land on the same signal
Impaired heme production, leading to blood cells with less oxygen-carrying hemoglobin and, over time, microcytic anemia
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A local anesthetic and corticosteroids are injected into the identified trigger point, relieving the muscle pain in the affected muscle group
How often should B12 shots be administered