A blood test will confirm a deficiency, with typical thresholds being total B12 levels under 180 nanograms per litre or active B12 below 25 pmol/l
Nasr et al
Yes, tirzepatide is associated with modest increases in heart rate, averaging 2-4 beats per minute, which is consistent with the class effect observed with GLP-1 receptor agonists
Extended escalation for sensitive patients Some patients metabolize tirzepatide more slowly or have greater sensitivity to GI side effects
Animal studies have revealed embryofetal toxicity at supratherapeutic doses
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