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Making your decision: the practical framework After reviewing all the dosage data, side effects, timelines, and mechanisms, the decision between retatrutide and tirzepatide comes down to a handful of practical questions

Certain populations are at higher risk of vitamin B12 deficiency, including older adults (due to reduced gastric acid production), individuals following strict vegan or vegetarian diets, those with pernicious anaemia (an autoimmune condition affecting intrinsic factor production), patients who have undergone gastric or ileal surgery (including bariatric procedures), and those taking medications that affect gastric acid secretion (such as proton pump inhibitors or H2 antagonists) or intestinal absorption (including metformin)