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Indeed, in pre-clinical models, retatrutide, a triple agonist (GLP-1/GIP/glucagon), resulted in greater WL and improved glucose profile compared to tirzepatide through increased energy expenditure and reduced calorie intake [80, 81]

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Lack of serum B12 levels or methylmalonic acid/homocysteine measurements: The diagnosis of B12 deficiency, although clinically justified, would have been more robust with documented low B12 levels and elevated methylmalonic acid/homocysteine

Pregnant or breastfeeding women: Our team is committed to making sure that the mother and child, including managing B12 levels during these critical periods

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