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doi: 10.1093/hmg/ddl215

Malabsorption Disorders: Conditions such as pernicious anemia, Crohns disease, celiac disease, or a history of gastric bypass surgery can hinder B12 absorption

The symptoms more likely reflect medication intolerance requiring dose adjustment and supportive care rather than vitamin supplementation

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If you have a history of eating disorders, pursue tirzepatide only with concurrent psychological support and close monitoring for disorder recurrence