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For users on tirzepatide monotherapy, blood sugar related sleep disruption is usually mild and resolves as the body adapts to the new metabolic patterns, typically within 2-4 weeks of starting or increasing the dose

The most common methods for supplementation are vitamin B12 injections and oral supplements

Diagnosis typically involves blood tests including full blood count (showing macrocytosis), anti-intrinsic factor antibodies (which are specific for pernicious anaemia), and sometimes anti-parietal cell antibodies

If what they wanted for their care is not one of these two options, theres not much we can do about that