tirzepatide dosage starting Zepbound® Guide Starting Tirzepatide at 5mg: Dosage
Description
Patients are encouraged to maintain a consistent eating schedule to help regulate blood sugar levels effectively

They dont say its required

Persistent or worsening symptoms are not expected and should be discussed with a medical professional

(PUBMED: Reference #1, Reference #2, Reference #3) B12 is added to alleviate the nauseous side effects that Tirzepatide can have on some patients

Beyond nausea, early dosing can worsen other GI symptoms

10.1007/s10557-018-06846-w 27