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Currently, there is no strong evidence that tirzepatide directly causes vitamin B12 deficiency

Watts RN

The crude material was purified by automated flash column chromatography on silica via gradient elution, from 100% dichloromethane to 1% methanol in dichloromethane to produce SS(NHS-CM) 2 (979 mg, 79%) as an off-white foamy solid

This is one of the invisible quality differences between compounding pharmacies

A vaginally-administered tablet formulation of micronised progesterone was also developed by Besins Healthcare for the treatment of female infertility, menopausal syndrome, menstrual disorders and endometriosis