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It is important to note that there is no official established link between Mounjaro and vitamin B12 deficiency in the current evidence base

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This inhibition reduces intracellular 1-methylnicotinamide (1-MNA) production (EC50 = 2.3 M) and preserves nicotinamide availability for the NAD+ salvage pathway

[DOI] [PMC free article] [PubMed] [Google Scholar] Alsarraf E, Myers J, Culbreth S, Fanikos J (2019) Kratom from head to toecase reviews of adverse events and toxicities

If serum calcitonin is measured and found to be elevated, the patient should be further evaluated