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Hydroxocobalamin tends to remain in the body longer and is more readily converted to the active coenzyme forms of B, which can make it effective for maintaining B levels

Phase 1: Establish tirzepatide baseline (weeks 1-4) Start tirzepatide alone at 2.5mg weekly

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This places the compound within a broader research context involving NAD+ biology, sirtuin signaling, and methylation-dependent gene regulation