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As a general rule, IM is favored when the goal is rapid correction of a clinical deficiency, when the patient has difficulty absorbing B12 through oral or sublingual routes, or when a provider wants predictable peak serum levels
Not everyone taking tirzepatide will need B12 supplementation
So its important to maintain normal levels of vitamin B12
The peptide community has accumulated substantial anecdotal experience, but anecdotes are not epidemiology
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