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People at higher risk for B12 deficiency while on tirzepatide include those who also take metformin, people over 65 (who naturally absorb less B12), vegans or vegetarians who eat few animal products, anyone with a history of GI conditions like Crohn's disease or celiac disease, and people who have had gastric surgery
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Additionally, it is used in the biosynthesis of glutathione [33, 35]
It is possible that the lower ghrelin levels in the obese may be a consequence of overconsumption, instead of the cause of the signal to other brain regions
