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By activating both incretin pathways, tirzepatide enhances insulin secretion in a glucose-dependent manner, suppresses glucagon release, delays gastric emptying, and reduces appetite through central nervous system effects

As B12 is essential for the production of red blood cells and proper nervous system function, its deficiency can disrupt these processes and lead to symptoms like gastrointestinal discomfort and poor appetite, which may contribute to unintended weight loss

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