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Sergey Terushkin, MD, FACS Starting dose: 2.5 mg weekly Dose escalation: every 4 weeks Maintenance dose: 515 mg Maximum dose: 15 mg Starting dose: 0.25 mg weekly Dose escalation: every 4 weeks Maintenance dose: 12.4 mg Maximum dose: 2.4 mg Learn More About: Tirzepatide Before and After Results: Weight Loss Timelines (2026) Compounded medications are prepared by licensed pharmacies and may be prescribed when appropriate

Shelf life up to 24 months when stored lyophilized

For those with a temporary deficiency or improved dietary intake, our providers may recommend switching to oral supplements or eventually discontinuing injections altogetheralways under careful medical supervision

Peptides are short chains of amino acids that function as messenger signals in the body, enhancing cellular function

This can last for 1-2 weeks and settles once the vitamin B12 supplements have been stopped