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Long-term deficiency may lead to more serious health issues like anemia, nerve damage, and cognitive problems

Severe gastroparesis or other serious gastrointestinal disorders, because tirzepatide slows stomach emptying, which can aggravate these conditions

The average cost of compounded tirzepatide with vitamin B12 is $300 to $500 per month, depending on the dose strength and formulation

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Phase 1: Establish tirzepatide baseline (weeks 1-4) Start tirzepatide alone at 2.5mg weekly