Unlike metformin, which has a well-established association with B12 deficiency, tirzepatide has not demonstrated a direct mechanism affecting B12 absorption
[13] [14] It remains under clinical investigation, and any reported skin-related symptoms should be interpreted within the context of emerging, rather than fully established, evidence
A literature search was conducted covering studies published between 2016 and 2025 using platforms including PubMed, Web of Science (WoS), Scopus, and Google Scholar
Heliyon 10 , e34355 (2024)
All outcomes of interest were dichotomous, first preferentially extracting data from ClinicalTrials.gov and secondarily selecting data from the original trial publication or secondary analysis of the same trial