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Other groups at risk of inadequate vitamin B12 intake or absorption include: Strict vegetarians and vegans People who have had stomach stapling or weight loss surgery People with Celiac or Crohns disease People who frequently use prescription drugs to control heartburn People with autoimmune diseases People who smoke People who consume a lot of alcohol People who have used a lot of antibiotics Some people might not consume enough vitamin B12 rich foods, and others cant absorb enough B12 through their diets no matter how much they take in if without intrinsic factors

4 In addition to its effects on glucose, metformin has been shown to have anti-inflammatory properties via inhibition of the nuclear factor B and mammalian target of rapamycin (mTOR) pathways, leading to decreased production of cytokines associated with T helper (Th) 1 and Th17 cell responses, such as IL-17, interferon gamma (IFN-), and tumor necrosis factor (TNF-)

Tirzepatide is typically well-tolerated, though gastrointestinal issues like nausea and vomiting are the most common complaints