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Only practical if your compounding pharmacy is local and the cost difference isn't prohibitive

numbness alone is an atypical feature

For most people with normal GI function, a quality capsule or tablet containing methylcobalamin is equally effective

This is especially relevant if you are taking supplements alongside tirzepatide or combining it with other medications like metformin or berberine

Physical examination revealed burning paresthesia and allodynia localized to the right C2 dermatome, with a Visual AnalogScale (VAS) score rated five on a ten-point scale