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Tirzepatide disrupts this cascade at multiple points

If you suspect B12 deficiency, blood testing can confirm your serum B12 level and guide an appropriate supplementation strategy in consultation with your healthcare provider.

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Clin Pharmacokinet 43(8):487514 Szumlanski CL, Honchel R, Scott MC, Weinshilboum RM (1992) Human liver thiopurine methyltransferase pharmacogenetics: biochemical properties, liver-erythrocyte correlation and presence of isozymes