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About 10% of tirzepatide participants had a heart-rate increase above 20 bpm during escalation, compared with 3% on placebo. A lean Japanese cohort reached +10 to +13 bpm, and 23% of Japanese participants at 15 mg crossed the abnormal-pulse threshold versus 7% of other participants, despite only 17% higher exposure. Lean and East Asian bodies showed greater cardiovascular sensitivity than exposure alone predicted

The increase in your B12 levels will also be fairly slow, meaning that it isnt a great option for those patients who need to see them boosted fairly quickly

Do not wait for routine labs Chest pain, fainting, severe shortness of breath, confusion, or new neurologic symptoms need medical review