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Last year, a twentysomething man Ill call Michael, who regularly lifts weights and practices jiujitsu, began struggling with fatigue and weight gain after starting a new job and recovering from a bad bout of COVID

Major sources include: Foods Rich in Vitamin B12 Vitamin B12 is naturally found primarily in animal-based foods, such as: Beef liver and pork liver (the most concentrated sources) Red meat, poultry, and fish Eggs, especially egg yolks Shellfish such as clams and oysters Fatty fish like salmon, tuna, and sardines Dairy products including cows milk, yogurt, and cheese For individuals who follow a vegetarian diet, Vitamin B12-fortified foods can be a helpful choice, such as fortified cereals or fortified soy milk

Journal (Journal of Applied Physiology, 2011, 110(3), 774780)

B12 may enhance overall treatment adherence B12 can enhance treatment adherence while on tirzepatide therapy

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Traditionally this has been called washerwoman's hands or washerwoman's changes, though a better designation on the autopsy report would be cutaneous changes of immersion (Image 4)