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After starting and after each dose increase, tirzepatide can cut the peak absorption of an oral contraceptive by more than half, so the label guidance is a non-oral method or added barrier protection for four weeks after starting and four weeks after each increase. It is a first-dose-and-escalation effect, not a permanent block on all oral drugs

Signs of a B12 deficiency include: pain tingling difficulty walking uncontrollable muscle movements confusion, forgetfulness, or memory loss changes in mental state or mood changes in smell or taste vision problems diarrhea weight loss glossitis, aka a painful, smooth, and red tongue If you have any of the above symptoms, talk with a doc

MOTS-c does neither