b12 injections from germany VITAMIN PANPHARMA, 1000 μg/ml, Injektionslösung, 10 ml Solution Germany (Original Product from Germany) PZN Neurobion Injection (Vitamin B1 +

and patients with pernicious anemia who have optic neuropathy COBALAMIN (Vitamin B12) Deficiency Causes Vegetarians (dietary deficiency) Older adults: atrophic gastritis affects 10% 30% and leads to decrease in hydrochloric acid secretion in the stomach and decreased absorption of Vitamin B12 The liver can store up to six years worth of Vitamin B12 so deficiencies are rare Effects of deficiency Megaloblastic anaemia (pernicious anaemia) Progressive demyelination of nerve cells Elevation in levels of circulating homocysteine that leads to production of defective collagen and elastin with a negative impact on arteries, bone and skin Deep vein thrombosis is associated with homocysteinemia that causes the activation of the intrinsic coagulation cascade Symptoms include fatigue, weakness, constipation, loss of appetite and weight loss Numbness, tingling of the feet imbalance, depression, confusion, dementia, poor memory and glossitis

London: Pharmaceutical press

Tirzepatide causes gastrointestinal symptoms including nausea, vomiting, diarrhea, and constipation in a substantial percentage of users, particularly during dose escalation phases

observed that this may limit gains in fat stores in obese murine models by over 50% (4)