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When present, the hematologic manifestations of vitamin B12 deficiency include macrocytic anemia with macro-ovalocytes and macro-erythrocytes (or macrocytes), hypersegmentation of neutrophil nuclei, variable polychromasia, neutropenia, and megaloblastic changes in the bone marrow

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Patients should discuss all available FDA-approved tirzepatide options with a licensed clinician to understand which treatment may be suitable for their needs

If ultrasound findings suggest there are gallstones in the common bile duct, an imaging test called magnetic resonance cholangiopancreatography (MRCP) may be used for confirmation (Jones, Ghassemzadeh 2018)

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