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Since it influences metabolic pathways, unknown downstream effects are possible

Special Populations Post-Bariatric Surgery Patients : Individuals who have undergone bariatric surgery, such as Roux-en-Y gastric bypass, are at a higher risk of vitamin B12 deficiency due to malabsorption

Journal of Orthopaedic Research, 29(1), 144-150

Your gut can only absorb a fraction of the B12 you swallow, especially if you have low stomach acid or any digestive issues

Freezing reconstituted tirzepatide is a debated topic

Melanin-concentrating hormone 1-receptor antagonist suppresses body weight gain correlated with high receptor occupancy levels in diet-induced obesity mice