I also follow a strict wheat and gluten free diet, so I don't knowingly supplement my B12 intake from food
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In particular, B12 is central to energy production and maintaining processes related to blood and the brain
After starting and after each dose increase, tirzepatide can cut the peak absorption of an oral contraceptive by more than half, so the label guidance is a non-oral method or added barrier protection for four weeks after starting and four weeks after each increase. It is a first-dose-and-escalation effect, not a permanent block on all oral drugs
[1] Unlike fat-soluble vitamins that accumulate in body tissues, water-soluble vitamins are generally excreted through urine when consumed in excess
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