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Who should consider alternatives Given the emerging safety data, several groups should particularly consider switching to a B12-free tirzepatide formulation with separate B12 supplementation

A pen, vial, compounded medication, provider-directed peptide therapy, or research-use product can raise different supply questions

10.1177/2515690X211036875 J Evid Based Integr Med

10.1016/0014-5793(94)01368-B [DOI] [PubMed] [Google Scholar] Traverso N., Ricciarelli R., Nitti M., Marengo B., Furfaro A.L., Pronzato M.A., Marinari U.M., and Domenicotti C

In this extensive study, the authors found an age-dependent increase in HCys and MMA concentrations, which were inversely related to eGFR, indicating that not age per se, but rather the age-dependent decrease in GFR is responsible for the increase in MMA and HCys when GFR is below 36 mL/min