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Eli Lillys testing showed that when tirzepatide is mixed with B12 (methylcobalamin or cyanocobalamin), a chemical reaction creates a new, unstudied chemical compound
That can slow how the dose is used and is a known issue, particularly in women and larger patients where there is more tissue to pass through
Dehydration is the most common cause, since nausea reduces fluid intake while GI effects increase fluid losses
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