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Vitamin B 12 stores in the liver last 35 years, meaning deficiency symptoms may take time to manifest, complicating direct causality assessments

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This high cost, along with limited manufacturing supply, means usage has remained mostly concentrated in wealthier countries (notably the US and parts of Europe) and among patients who can afford to pay

Tirzepatide (Mounjaro, Zepbound) is a dual GIP/GLP-1 receptor agonist with a slightly different mechanism

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