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We also look at methylmalonic acid (MMA) or homocysteine levels sometimes

PMID 26024497

Symptoms of B12 deficiency B12 deficiency produces symptoms that overlap frustratingly with common tirzepatide side effects : Fatigue and low energy : Often attributed to reduced caloric intake Brain fog and poor concentration : Mistaken for a dietary side effect Mood changes : Depression, irritability, anxiety Tingling in hands or feet : Peripheral neuropathy from B12 depletion Weakness : Often blamed on muscle-related side effects Because these symptoms mirror common GLP-1 side effects, B12 deficiency often goes unrecognized in people taking tirzepatide

A lot depends on your current B12 levels and the results you're aiming for