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Zepbound and Retatrutide do share the same baseline of gastrointestinal side effects (like nausea and constipation), however, because Retatrutide targets a third hormone (glucagon), it introduces a couple of side effects not seen with Zepbound, specifically related to heart rate and skin sensitivity

[10] [11] Therefore, any B12 deficiency detected in a patient taking Mounjaro may actually be attributable to metformin rather than tirzepatide itself