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Inherited disorders of vitamin B 12 absorption Rare cases of inborn errors of vitamin B 12 metabolism have been reported in the literature (reviewed in 6)

Tirzepatide was not just treating existing metabolic dysfunction

This was best summed up in a BMJ editorial last year, which noted that diagnosing B12 deficiency can be "challenging" because no "single specific measurement exists to reliably diagnose or refute the presence of B12 deficiency"