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If the medication causes fatigue and the resulting caloric restriction depletes B12, then providing supplemental B12 directly in the injection could mitigate both problems simultaneously

This may explain the subtle manifestations of the FCM in some patient, especially in the early stages

PMID: 9384660

The entire analysis was performed using pyEMMA 66 freely available at github ( Reporting summary Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article

Since tirzepatide also slows gastric emptying, this effect can be compounded and worsen digestive upset

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