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Healthcare providers should maintain a low threshold for investigating unexplained fatigue or other symptoms potentially attributable to anemia, recognizing that while tirzepatide does not directly cause anemia, the metabolic and gastrointestinal changes it produces could theoretically affect nutritional status in some individuals

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Patients taking tirzepatide should already be prioritizing hydration

Tirzepatide niacinamide complete guide explains the rationale: niacinamide (vitamin B3) supports cellular energy metabolism and may enhance insulin sensitivity independently