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Importantly, tirzepatide carries a boxed warning for risk of thyroid C-cell tumors and is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

Therefore, oral B12 supplements can be taken with or without food with minimal impact on absorption

Other possible effects include fatigue or transient increases in heart rate during activity

Optimise your nutrition Fix any gut issues Check MTHFR, MTRR, MTR and other associated genes for mutations and supplement if necessary Consult your Functional Medicine health practitioner about which form of B12 supplement is best for your condition