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But here is what makes dosage so critical

Most elevated B12 levels are asymptomatic and discovered incidentally during blood tests

When specific GLP-1 RAs were evaluated compared to placebo and other antidiabetic drugs, liraglutide was found to increase risk of thyroid disorders by 37% and dulaglutide in similar comparisons increased risk by 96%

Vitamin B12 functions as a cofactor for two essential enzymes: methionine synthase (involved in homocysteine metabolism and DNA synthesis) and methylmalonyl-CoA mutase (crucial for fatty acid and amino acid metabolism)

Switching GLP-1 medications is a conversation for your prescribing provider, but tirzepatide represents an option worth discussing if muscle preservation is a primary concern