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Although its not fully understood, several factors appear to be at play: 1

Requirements of Vitamin B12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation

History of severe hypersensitivity reactions to tirzepatide or any formulation component requires avoidance

Weight reduction with type 2 diabetes: In REDEFINE 2 the combination produced about 15.7% mean weight loss versus placebo over 68 weeks in adults with T2D [2]

Blephaclean wipes improved ocular symptoms, with patients reporting less crusting around the eyelashes, redness around lid margins, heavy or puffy eyelids and eyelids stuck together in the mornings