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Vitamin b12 deficiency symptoms can include peripheral neuropathy (numbness and tingling in the hands and feet), problems with balance and coordination, memory loss, trouble concentrating, changes in mental status, and depression, among other symptoms

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Tirzepatide can remain at room temperature (up to 77F) for up to 30 days if the vial remains sealed and unopened

doi: 10.1038/s41392-022-01270-x 20 HuJArvejehPMBoneSHettEMarincolaFMRohK-H

(ref) Hsieh MJ, Liu HT, Wang CN, Huang HY, Lin Y, Ko YS, Wang JS, Chang VH, Pang JS