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By taking it in the morning, you allow your body to better process it and maintain its natural circadian rhythm

Many people lack both nutrients

Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)

Yes, tirzepatide can indirectly cause menstrual irregularities through significant weight loss and metabolic changes that affect reproductive hormone balance