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To understand why GP practices sometimes differ from these guidelines and what that can mean for you, you can read more about the nuances of B12 guidelines

Light exposure, particularly UV light, degrades both tirzepatide and B12 to some degree

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Possible adverse effects may include: Injection site reactions : Redness, swelling, irritation, or discomfort Gastrointestinal symptoms : Nausea, vomiting, stomach cramps, or diarrhea Headaches or dizziness Allergic reactions : Rash, itching, shortness of breath, or facial swelling (rare) Increased heart rate or anxiety (typically temporary from B-vitamins) Fatigue or weakness if used improperly Elevated liver enzymes when taken in excess particularly with methionine or choline Insomnia if taken late in the day due to increased energy levels Who should avoid or use caution