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But heres what we do know: Some people experience gastrointestinal side effects on tirzepatide, such as nausea, vomiting, diarrhea, or constipation Vitamin B12 supplementation is generally considered safe, but high doses might cause headache, nausea, or bowel changes Side effects for both usually improve with time as the body adjusts If youre curious about taking tirzepatide and B12 together or if you are unsure whether you may have nutritional deficiencies, talk to your provider before making any changes