vitamin b12 injection overdose symptoms B12: Symptoms, Dosage & Toxicity Risks Vitamin B12 - Wikipedia
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By preserving NAD+ levels, it supports mitochondrial health within muscle cells, which is essential for energy production and repair
(PubMed) Hendler S, Rorvik D, eds
Potential drug interactions have not been systematically studied

As well, once you get to stage 4 deficiency you can get macrocytic anemia

Additionally, tirzepatide may affect how quickly alcohol is absorbed due to delayed gastric emptying, potentially altering your tolerance
