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Those who continued the medication maintained their results and lost additional weight

tirzepatide can do the same through its GLP-1 effects, albeit through a different neurochemical pathway

Clinical Manifestations of Vitamin B12 Deficiency Although the classic hematologic expression of vitamin B 12 deficiency is a megaloblastic macrocytic anemia characterized by an elevated mean corpuscular volume and mean corpuscular hemoglobin, and a peripheral smear containing macroovalocytes and hypersegmented neutrophils, up to 28 percent of affected patients may have a normal hemoglobin level, and up to 17 percent may have a normal mean corpuscular volume

If you want to be on the safe side, this test is the most precise option for early detection