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[1] Some compounders suggest adding B12 to tirzepatide formulations based on theoretical concerns about vitamin B12 absorption, though it's important to note that clinical evidence specifically linking tirzepatide to B12 deficiency is lacking

The Consequences of Long-Term Vitamin B12 Deficiency If a vitamin B12 deficiency is not recognised, gradually more and more symptoms appear

In a randomized, double-blind, placebo-controlled trial in 2,919 participants (65 years) with elevated blood concentrations of homocysteine, supplementation with vitamin B 12 (500 g/day) and folic acid (400 g/day) for two years did not decrease the risk of osteoporotic fracture despite reductions in homocysteine (120, 121)

Cells, 13(18), 1545.

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