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The pancreatic secretion of intrinsic factor is reduced or absent, secondary dysbiosis of the intestine is common, and the mucosa may be compromised by the presence of excessive bacterial numbers and toxic metabolites

The I.V

[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

In placebo-controlled trials, cholelithiasis was reported in 1.5% and 0.4% of patients treated with Ozempic injection 0.5 mg and 1 mg, respectively, and not reported in placebo-treated patients