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Additionally, hormonal changes associated with menopause and menstruation may influence vitamin B12 absorption and metabolism, potentially contributing to vitamin B12 deficiency

Trials did not pre-specify it, and the tirzepatide label does not list it
[DOI] [PubMed] [Google Scholar] 92.Spinnato J.A., Freire S., Pinto ESilva J.L., Cunha Rudge M.V., Martins-Costa S., Koch M.A., Goco N., Santos Cde B., Cecatti J.G., Costa R., et al

Closing: Why the Protocol Details Matter as Much as the Peptide Tesamorelin works because of what it is and how it is used
