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Vitamin B12 Deficiency and Management During Pregnancy In addition to anaemia, symptoms of vitamin B12 deficiency may include: Fatigue Breathlessness Nervous system symptoms such as numbness, tingling or poor balance Poor concentration or memory Paleness Mood changes, including low mood, anxiety or disrupted sleep Some women are more susceptible to vitamin B12 deficiency than others

This is the most foolproof method, but it means owning multiple pen bodies

The interesting thing is that our body can store vitamin B12 in the liver for a long time, so it might take a few years before you start to have a shortage of it in your body

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Adding cagrilintide to tirzepatide Theoretical protocol (not clinically studied): If on tirzepatide 10-15mg: Stable on tirzepatide for 4+ weeks Continue tirzepatide at current dose Add cagrilintide 0.6mg weekly Standard cagrilintide titration to 2.4mg Rationale: Tirzepatide is dual GIP/GLP-1 (very powerful alone) Adding amylin pathway could theoretically enhance No clinical data on this combination Uncertain if additional benefit over tirzepatide alone Concerns: GI side effects may be severe (both slow gastric emptying) Tirzepatide already produces 15-22% weight loss alone Unclear if cagrilintide adds meaningful benefit Expensive combination Verdict: Wait for clinical data