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But contrary to popular thought, low B12 might leave you straining
57 , 58 Cobalamin deficiency causes a decrease in hemoglobin levels, characterizing megaloblastic or pernicious anemia with manifestations that include skin pallor, decreased energy and exercise tolerance, fatigue, shortness of breath, and palpitations
Successful appeals require: A Letter of Medical Necessity from the prescribing provider that specifically addresses why tirzepatide is medically necessary for this patient, why alternative treatments are inadequate, and how the patient meets the payer clinical criteria
A fast, straightforward intramuscular injection of hydroxocobalamin
About the Authors Medically reviewed by Phyllis J
