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Stacked on top of insulin or a sulfonylurea it can, and the lever is de-intensifying that background drug, not lowering the tirzepatide dose. Over-loss in low-BMI deep responders Across the obesity trials, about 7% of participants fell below a BMI of 22, some by week 12

Optimal B12 Levels Chart We like the B12 range from Sally Pacholok and Jeffrey Stuarts book, Could It Be B12

Recovery and rejuvenation in one protocol

So the practical takeaway is not oral is better or SC is better. It is: pick one route, follow the documented per-dose figure for the vial you have, and keep the route constant so that whatever you observe is not confounded by a mid-stream route change