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Continue tirzepatide at 5mg weekly (first escalation)

Research literature suggests involvement in

Illness and conditions linked to B12 deficiency: Neuropsychiatric disorders - The earliest symptoms of B12 deficiency include: Irritability Mood swings Confusion Forgetfulness Fogginess Psychosis Hallucinations or delusion Depression Anxiety/Panic attacks Tension headaches Onset of dementia Neurological disorders Bells Palsy Chronic Fatigue Syndrome (CFS) Myalgic Encephalomyelitis (ME) Autoimmune Disorders - Autoimmune disorders take many forms

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The designated code for macrocytic anemia is ICD-10-CM Diagnosis Code D53.9