People over 60 absorb B12 less efficiently even without medication
107 During the first Trump Administration, CMS began phasing out the IPO list, starting with the removal of total knee arthroplasty (TKA) in 2018, followed by total hip arthroplasty (THA) in 2020

use alternative contraceptive methods during treatment initiation and for 4 weeks after each dose escalation [11] Concomitant medications: Avoid coadministration with other GLP-1 receptor agonists for weight management Patients should be advised to seek medical attention for: Severe, persistent abdominal pain that may radiate to the back (potential pancreatitis) Signs of thyroid tumors including neck mass, dysphagia, dyspnea, or persistent hoarseness Symptoms of acute gallbladder disease (right upper quadrant pain, fever, jaundice) Severe gastrointestinal symptoms leading to dehydration Changes in vision or signs of hypoglycemia Signs of hypersensitivity reactions including rash, itching, or difficulty breathing Clinicians should conduct a thorough medical history before initiating tirzepatide, including assessment for personal or family history of medullary thyroid carcinoma or MEN 2, history of pancreatitis, severe gastrointestinal disease, and diabetic retinopathy

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Addressing the deficiency without understanding why it developed in the first place means you are managing a symptom, not solving a problem
Targeted Assessment in High-Risk Patients With Diabetes to Identify Undiagnosed Heart Failure