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Keywords: severe anemia, thrombocytopenia, severe neutropenia, megaloblastic, hypercellular bone marrow, myelodysplastic syndrome mimic, bone marrow biopsy, vit b12 deficiency, myelodysplastic syndrome (mds), pancytopenia Introduction Vitamin B12 deficiency is a common condition estimated to be present in 3.6% of all adults over the age of 18 years that often presents with fatigue caused by macrocytic anemia [1]

Endurance athletes face unique challenges that may increase B12 needs: prolonged training sessions stress the digestive system, potentially impairing absorption, while increased red blood cell turnover demands consistent B12 availability

Activation of the coagulation system: This can lead to hypercoagulation and vascular blockage

The Standard 1000 mcg (1 mg) Dosage The 1000 mcg (1 mg) dose is the standard for adults

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Ozempic, whose active ingredient is semaglutide, is designed to mimic the beneficial actions of natural GLP-1