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B12 is just one of the many untested additives used in the mass production of compounded GLP-1s under the guise of personalization. Mass compounders and supposed personalizers seeking to circumvent the law are also mixing tirzepatide with glycine, pyridoxine, niacinamide, carnitine, or other chemicals, creating a range of new and untested combination drugs

Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

Check with your insurance provider if you're unsure whether your plan provides coverage for B12 shots