This is a non-negotiable clinical and legal requirement not a formality
It is recommended that adults over the age of 50 increase their sources of vitamin B12 through diet, fortified foods, B12 shots, or other supplements that can increase their B12 consumption. (By The National Institutes of Health) Persons who have gastrointestinal issues are particularly predisposed to issues with B12 deficiencies
Drugs@FDA: FDA-Approved Drugs (semaglutide, tirzepatide labeling)

Warning signs that need medical attention Seek medical evaluation within 24 to 48 hours if you experience: Redness that continues expanding beyond 48 hours after injection Redness diameter exceeding 10 centimeters Increasing pain (not decreasing) after 48 hours Warmth and hardness accompanied by fever above 100.4 F (38 C) Pus, drainage, or fluid oozing from the injection site Red streaks extending outward from the injection site (sign of lymphangitis) Reaction that has not shown any improvement after 7 days Seek emergency medical care immediately if you experience: Hives or rash spreading beyond the injection site to other body areas Swelling of the face, lips, tongue, or throat Difficulty breathing, wheezing, or shortness of breath Dizziness, lightheadedness, or feeling faint Rapid heartbeat Severe abdominal pain These emergency symptoms suggest a systemic allergic reaction (anaphylaxis), which is rare but documented with tirzepatide

First dose felt some nausea and fatigue, but that was over within the first week
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