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Shmerling & Greisen, 2025)

Vitamin B12, also known as cobalamin, is a crucial water-soluble vitamin that plays an essential role in red blood cell formation, nerve function, and DNA synthesis

Also known as/branded as: Insulin Like Growth Factor (IGF)-1 (4-70) DES IGF-1

The most frequently reported side effects for both include: Nausea (most common, especially during dose escalation) Diarrhea Constipation Vomiting Decreased appetite (technically the intended effect) Abdominal discomfort For tirzepatide, these side effects are well-characterized from multiple large Phase 3 trials and extensive real-world use

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