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416 - B12 Deficiency Secondary to Ozempic Use in an Adult Patient: A Case Report

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

QJ

Quinton Johnson, BS

Medical Student
Howard University College of Medicine
Hampton, Georgia, United States
NT

Nareka A. Trewick, MD

Resident Physician
University of Miami/Jackson Memorial Hospital
Miami, Florida, United States

Corresponding Author(s)

AL

Andrew Logan, MD

Interventional Pain Fellow
University of Miami / Jackson Health System
Coral Springs, Florida, United States

Co-Author(s)

DG

Deep S. Garg, MD

Physiatrist, Brain Injury Medicine
Mount Sinai Medical Center
Brooklyn, New York, United States

Case Diagnosis: B12 deficiency secondary to Ozempic use

Case Description: A 39-year-old female with a history of UTI and recent COVID-19 infection presented with progressive numbness and weakness in her lower extremities, leaving her unable to walk or feel her legs, and severe ascending dysesthesias extending to just below the diaphragm. She had started Ozempic for diabetes management before symptom onset. Neurological examination showed impaired proprioception, diminished vibration sensation, and reduced ankle reflexes, indicative of peripheral neuropathy. Lumbar puncture revealed elevated cerebrospinal fluid protein, initially suggesting Guillain-Barré syndrome. Further investigation identified B12 deficiency. High-dose parenteral B12 and corticosteroids led to significant improvement in motor function and sensation, with notable reduction in dysesthesias and gait difficulties during her hospital stay.

Discussions: B12 deficiency is a potential adverse effect of GLP-1 receptor agonists such as Ozempic, likely due to altered gastrointestinal physiology and nutrient absorption. Neurological manifestations of B12 deficiency can mimic other conditions, complicating diagnosis and management. This case underscores the importance of considering medication-induced nutritional deficiencies, particularly in patients with preexisting risk factors such as diabetes mellitus.

Conclusions: B12 deficiency should be considered in the differential diagnosis of neurological symptoms in patients receiving GLP-1 receptor agonists like Ozempic, especially in the context of gastrointestinal symptoms or risk factors for malabsorption. Early recognition and treatment of B12 deficiency are crucial for preventing long-term neurological sequelae and optimizing patient outcomes. Healthcare providers should remain vigilant for potential nutrient deficiencies in patients receiving chronic pharmacotherapy, particularly those with predisposing medical conditions.