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When B12 levels are insufficient, the bone marrow produces fewer but larger red blood cells a pattern known as megaloblastic anaemia

doi: 10.1111/j.1749-6632.2012.06538.x PMCID: PMC3384703 NIHMSID: NIHMS366557 Zonulin, regulation of tight junctions, and autoimmune diseases Alessio Fasano ~ Physiol Rev

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Women using oral contraceptives should use alternative or back-up contraception for 4 weeks after tirzepatide initiation and after each dose increase due to potential reduced effectiveness from delayed gastric emptying

Chapuy-Regaud S, Nogueira L, Clavel C, Sebbag M, Vincent C, Serre G