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What You Need to Know Harvard Health Publishing: The A List for Vitamin B-12 Sources National Institutes of Health Office of Dietary Supplements: Vitamin B12 Grant Chu, MD, MS, MBA, FACP Medical Reviewer Grant Chu, MD, is an associate clinical professor at the David Geffen School of Medicine at UCLA

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Quick Answer: Tirzepatide has no established direct effect on vitamin B12 levels, but indirect factors such as reduced dietary intake, slowed gastric emptying, and concurrent metformin use may increase deficiency risk

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People who benefit most include those with: Severe or intractable attacks that shrug off standard meds Status migrainosus (headaches lasting 72 hours or more) Intense nausea or vomiting that prevents oral treatment Dehydration-triggered or medication-overuse headaches A history of poor absorption or side-effects from tablets Unsure if you fit