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It cannot verify that the tirzepatide peptide is structurally intact and biologically active

PMID 37060552

Malabsorption: Cells in the stomach known as parietal cells create an intrinsic factor protein essential for B12 absorption

One of the primary reactions of methylcobalamin in the body is to convert homocysteine to methionine high homocysteine levels are undesirable and known to be an indicator of heart disease and stroke risk due to the fact free homocysteine in the blood causes sclerosis of the arteries, putting strain on the vascular system and the heart

Those same actions especially the slowed stomach emptying are what drive nausea, and the gut adapts to them only gradually

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