The Increlex label explicitly contraindicates use in patients with active or suspected neoplasia and notes that active or suspected malignancy should prompt discontinuation
The Australian Dental Association highlights this concern, stating that "Untreated tooth decay and gum disease can cause infections

These should include: Weight and BMI monitoring to assess treatment effectiveness Blood pressure checks , as weight loss can affect blood pressure Review of side effects and overall treatment tolerance Periodic blood tests as clinically indicated, which may include HbA1c (for diabetes monitoring), liver function tests, and renal function When to seek urgent medical advice: Symptoms of severe hypoglycaemia (confusion, loss of consciousness, seizures) Severe, persistent abdominal pain, which could indicate pancreatitis (a rare but serious side effect of GLP-1 receptor agonists) [2] [7] Sudden right upper abdominal pain, fever, or jaundice, which could indicate gallbladder disease (risk increased with rapid weight loss) Persistent vomiting leading to dehydration Signs of allergic reaction (rash, swelling, difficulty breathing) Symptoms of thyroid problems (lump in the neck, hoarseness, difficulty swallowing) Quality considerations for berberine supplements are important, as these products are not subject to the same regulatory oversight as medicines

The high B12 levels themselves are a minor issueexcess is harmless and there are no toxicity levels