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The longer someone uses tirzepatide, the greater their risk of developing B12 insufficiency or outright deficiency

Some chemotherapy drugs or antiretroviral medications (for HIV) that suppress bone marrow might also blunt the effectiveness of B therapy

Disclose Medications: Let your provider know about any medications you are taking, especially those for acid reflux or diabetes (like Metformin), as these can interfere with B12 levels

This is why B12 deficiency can occur in isolation, rather than alongside other B vitamin deficiencies, and why focusing only on dietary intake can overlook the root cause

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