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By activating both incretin pathways, tirzepatide enhances insulin secretion in a glucose-dependent manner, suppresses glucagon release, delays gastric emptying, and reduces appetite through central nervous system effects

The goal is not only to prevent deficiency but also to support better energy metabolism and more effective fat-burning

In some cases, people report new breakouts or worsening acne, which can feel unexpected

This may seem trivial now, but might not if we get to the stage where all who follow vegetarian diets are dismissed early on by GPs as having dietary B12 deficiencies

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For patients with confirmed pernicious anaemia or malabsorption disorders, injectable therapy remains the recommended first-line treatment according to NICE CKS guidance, as oral supplementationregardless of dosecannot reliably correct deficiency in these circumstances