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Yes, high doses of folic acid can mask the anaemia symptoms of vitamin B12 deficiency whilst allowing potentially irreversible neurological damage to progress

After starting and after each dose increase, tirzepatide can cut the peak absorption of an oral contraceptive by more than half, so the label guidance is a non-oral method or added barrier protection for four weeks after starting and four weeks after each increase. It is a first-dose-and-escalation effect, not a permanent block on all oral drugs

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Cobalamin deficiencies or a lack of Vitamin B12 can also lead to issues such as anemia or the feeling of fatigue and cognitive problems in most people