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Methylcobalamin is the active cobalamin coenzyme that participates in the methionine synthase reaction

In trials that added it to injected insulin, basal insulin requirements fell roughly 60% to 80% while control improved. Low-blood-sugar risk therefore tracks the insulin or sulfonylurea used alongside tirzepatide more than the tirzepatide dose itself

If your pharmacy includes B12 at a lower concentration, you may want to supplement with additional oral or sublingual B12 between injections, especially at lower semaglutide doses where injection volume (and therefore B12 delivery) is minimal

However, if youre pregnant or breastfeeding, please speak to your GP before starting any treatment plans with Vitamin B12