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A vitamin B12 injection is needed after gastric banding when oral supplementation has failed to correct a documented deficiency, serum B12 remains persistently low, the patient cannot adhere to daily oral tablets, or there are signs of neurological or haematological complications

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Tirzepatide is FDA-approved to treat type 2 diabetes and support weight loss by activating two hormone pathways, GIP and GLP-1, that regulate blood sugar and appetite

But they are usually present only during the early weeks and during dose upgrades