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Red or purple chromaturia is a side effect of hydroxocobalamin, typically resolving over several weeks.2 Additional causes of red urine include blood (e.g., traumatic catheterization, malignancy, infection), dietary ingestion (e.g., beets), and medications (e.g., rifampin, phenothiazines).3 Although benign and not warranting further evaluation by itself, hydroxocobalamin-induced discolouration of body fluids may interfere with colorimetric sensors

Int J Biol Sci (2018) 14:1696708

How Tirzepatide Works Tirzepatide simultaneously activates two incretin hormone receptors: GLP-1 (Glucagon-Like Peptide-1): Reduces appetite, slows gastric emptying, and stimulates insulin secretion in a glucose-dependent manner

You may also regain any weight they lost while using it