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This is a concern that applies to all significant weight loss interventions, not just tirzepatide, but it becomes more relevant as the magnitude of weight loss increases

DOI: 10.1056/NEJMoa0909747

This mechanism is completely distinct from growth hormones receptor-mediated actions

Vitamin B12 Vitamin B12 is essential for neurologic function and red blood cell production

[4] Red flag symptoms requiring immediate medical assessment include: progressive or worsening neurological symptoms, changes in vision, significant gait disturbance, or cognitive decline