database analysis of 461,382 adults on GLP-1 medications revealed the following deficiency progression[2]Nutritional Deficiencies in GLP-1 Users NCBI View source: The comparison against other diabetes medications is especially stark: These numbers reflect a consistent pharmacodynamic pattern.[12]Vitamin D and Peripheral Neuropathy Muscle Nerve View source The risk is highest in the first year of treatment and compounds over time without proactive supplementation.[11]Vitamin D Status and B12 Interaction J Nutr Sci View source Clinical Consequences of Vitamin D Depletion During Weight Loss Vitamin D deficiency during rapid weight loss is not a minor inconvenience it has compounding clinical consequences that can undermine the benefits of GLP-1 therapy[3]Vitamin D Deficiency Mayo Clinic View source: Accelerated bone loss vitamin D is required for calcium absorption.[13]Vitamin D Deficiency and Neurological Manifestations Nutrients View source Without it, your body pulls calcium from bone to maintain serum levels, increasing fracture risk during the very period you are losing weight rapidly see our article on vitamin D and osteoporosis prevention Muscle weakness and fatigue vitamin D receptors are present in muscle tissue

And while not quite as effective as injectables, it is more accessible for some
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"Additional studies are needed on the balance of prepregnancy benefits of GLP-1s with the risks associated with interrupting them for pregnancy," senior author Camille E