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Full breakdown of the pathway, the regulatory citations, and the documented medical-need criteria RxPepsDirect providers use is on our compounded tirzepatide legality page

This decision has led to varied opinions and discussions in the health community

Certain populations face higher deficiency risk: vegetarians and vegans (B12 is primarily found in animal products), adults over 50 (decreased stomach acid reduces B12 absorption), individuals with digestive disorders like Crohn's disease or celiac disease, and those taking medications like metformin or proton pump inhibitors

No human pharmacokinetic data exists to confirm whether these doses translate to effective systemic exposure