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Until safety data exists, avoiding use during these periods is the only prudent approach

44 Additionally, in patients who are already taking some form of oral B 12 supplementation, demonstrating B 12 deficiency can be a challenge, even when symptoms are typical (including those of neuropathy-like paraesthesia and numbness) as serum B 12 concentrations may be just within, or sometimes above, the normal range

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For a broader look at how genuinely effective modern fat-loss pharmacology behaves in trials a useful contrast the analysis of how tirzepatide improves fat loss and insulin sensitivity in clinical research shows what a statistically decisive weight-loss result looks like by comparison