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Safe choices: Methylcellulose (zero fermentation, zero gas), calcium polycarbophil (zero fermentation), psyllium (very low fermentation)

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(3) If the patient has high-risk factors for gastrointestinal bleeding, such as a history of gastrointestinal diseases (e.g., peptic ulcer disease and its complications), age 65 or older, or concurrent use of corticosteroids, anticoagulants, or non-steroidal anti-inflammatory drugs (NSAIDs), preventive measures should be implemented

There are no clinical studies on compounded tirzepatide + B12 that prove these benefits