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10.1038/nm.4324 [DOI] [PMC free article] [PubMed] [Google Scholar] Jonitz A., Lochner K., Tischer T., Hansmann D., Bader R

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Constipation is less dose-dependent and can persist, making it a more durable reason for discontinuation in patient reports. Sulfur burps reflect food sitting longer in a slowed stomach. Fatigue ranks second only to nausea in patient forums, although much of it tracks the calorie deficit rather than tirzepatide itself. Fried or fatty foods, coffee, meat, and alcohol can also become less appealing

You should maintain a routine until your symptoms clear up, and then follow your doctors specific maintenance regimen if you suffer from conditions that lead to B12 deficiencies or already have a deficiency