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If you have accidentally left your vial out, our guide on how long compounded tirzepatide can be out of the fridge helps you assess viability, and what happens if tirzepatide gets warm explains the degradation mechanism

Proteins such as apolipoprotein C3 (APOC3), APOA1, stathmin 1 (STMN1), HSPB1, p21 (RAC1) activated kinase 2 (PAK2), TGF-, apoptosis-inducing enzyme caspase-3 (CASP3), COL1A2, collagen type IV alpha 1 chain (COL4A1), laminin subunit beta 4 (LAMB4), and THBS1 were found to be significantly enriched in these pathways [52]

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Cancer Metab 1(1):7 Avolio R, Swann Matassa D, Criscuolo D, Landriscina M, Esposito F (2020) Modulation of mitochondrial metabolic reprogramming and oxidative stress to overcome chemoresistance in cancer

So, when your B12 is low, its no wonder you feel drained