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Despite the Biden administration's 2024 proposal to reinterpret the statutory exclusion of weight-loss drugs, the Trump administration declined to finalize that change in April 2025

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Monitoring and follow-up Monitor clinically and repeat tests as indicated by the underlying condition Ongoing monitoring of liver function, renal function, and FBC as clinically indicated Regular review in primary care or specialist clinics for underlying conditions Patient advice: Patients should understand that elevated B12 is a marker requiring investigation rather than a condition requiring direct treatment

In rare cases, stones can still form in the bile ducts themselves, so any severe upper abdominal pain should be evaluated by a doctor