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The proposed mechanisms may involve the same binding proteins, with haptocorrin produced by some tumors and by the granulocytic response, raising the measured B12

The incidence of severe gastrointestinal adverse events leading to treatment discontinuation was higher with tirzepatide compared to some comparators but remained within acceptable ranges for most patients

In sum, metformin is likely to cause deficiencies of vitamin B12

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Known Side Effects Reported side effects are generally mild and infrequent: Injection site reactions: temporary redness, mild swelling, or tenderness Nausea: occasionally reported, usually mild and transient Dizziness: rare, typically with first doses Fatigue: some users report temporary tiredness Headache: infrequent, usually resolves quickly These effects typically diminish with continued use and rarely require treatment discontinuation