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Short-term, the safety profile is favorable

Gastrointestinal effects lead: nausea, diarrhea, constipation, and vomiting, dose-dependent and clustered during escalation, mostly mild. Tirzepatide also produces a modest chronic heart-rate rise with a larger escalation-phase peak. Oral-contraceptive absorption can fall after starting and after each increase, so use backup or non-oral contraception for 4 weeks each time. What is known about concurrent metformin and tirzepatide use

At disease progression or relapse, available systemic agents such as temozolomide, lomustine, and bevacizumab have limited efficacy

No, diarrhoea is an uncommon side effect of vitamin B12 supplementation

Prolonged deficiency allows more extensive damage to accumulate, particularly to the nervous system, which requires longer to repair

Sequences of primers used for Q-PCR can be found as Supplementary Table 1