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On keto, glycogen is already low

By the way, even if you dont have pernicious anemia, but a severe B12 deficiency due to other causes, B12 shots are still the way to go

Vicario M, Amat C, Rivero M, et al

3.3.2 HbA1c changes The comparison between Semaglutide and Liraglutide regarding their impact on HbA1c levels yielded a pooled effect size of 0.56 (95% CI: 0.190.94

Elastin content, cross-links, and mRNA in normal and aneurysmal human aorta

[128] The FDA cautioned that formulations containing semaglutide sodium or semaglutide acetate had not yet been shown to be safe and effective, and stated that moreover, the FDA does not evaluate compounded drugs for safety and effectiveness