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Loss of sterility: Over extended time, the preservatives in injectable formulations may weaken, increasing the risk of bacterial contamination

In humans, where C-cell GIP receptor expression appears to be lower, this effect may be minimal GIP and thyroid blood flow: Some preclinical data suggest GIP influences thyroid gland blood flow, which could theoretically affect hormone production and levothyroxine absorption in patients with remaining thyroid tissue No adverse thyroid effects in trials: In the SURMOUNT and SURPASS clinical trials, tirzepatide did not produce clinically significant changes in thyroid function tests in participants with normal thyroid function The presence of GIP receptors on thyroid tissue is an area of active research

Individuals who adhere to a diet where B12 intake may be limited, are also good candidates, as well as individuals with conditions that affect B12 absorption

Weight Loss Medications and Hormonal Balance in Women. American Journal of Obstetrics & Gynecology, 230(1), 45-60.