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Additionally, there is a small risk of developing thyroid tumors, which has been observed in animal studies

Phase I studies of the safety, tolerability, pharmacokinetics and pharmacodynamics of the dual glucagon receptor/glucagonlike peptide1 receptor agonist BI 456906.Diabetes, Obesity and Metabolism 2023;25:1011-23

PMID: 31189503 15 Primary carnitine deficiency - diagnosis after heart transplantation: better late than never

Effects of oral liposomal glutathione in altering immune responses against Mycobacterium tuberculosis and the Mycobacterium bovis BCG strain in individuals with type 2 diabetes

Also, anyone following a vegan diet is more at risk as B12 is mainly found in animal sources of food