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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

Most compounded tirzepatide vials have a beyond-use date of 30 to 90 days from the date of compounding, assuming proper storage