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Where the evidence gets more modest is in non-deficient populations

Commercial tirzepatide products (Mounjaro, Zepbound) use even higher concentrations in their pre-filled injection pens

These symptoms often affect work, concentration, and quality of life

Injections are particularly appropriate for those with: Pernicious anaemia, an autoimmune condition affecting B12 absorption Conditions affecting the stomach or small intestine, such as Crohns disease or coeliac disease Those who have had gastric surgery or bariatric procedures Strict vegans and vegetarians not meeting their B12 needs through food or oral supplements For those who can absorb B12 normally, oral supplements are generally an effective and well-evidenced alternative to injections