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Frank deficiency (below 145 pmol/L): I start aggressive supplementation, often intramuscular for post-RYGB patients, and I will want repletion confirmed on a follow-up blood test before I am comfortable proceeding with surgery

Tirzepatide reduces calorie intake by suppressing appetite

Its also what doctors follow when treating cyanide poisoning or controlling homocysteine

the most frequent reasons for refusal were the possible side effects (46%), cost to the patient (33%), possible long-term effects (30%), and frequency of treatment (30%)

Jakubowski H, Zhang L, Bardeguez A, and Aviv A (2000)

If symptoms persist through these treatments, some patients opt for surgical intervention