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Other than patients who have had their stomachs bypassed, there is also an autoimmune condition known as pernicious anemia that leads to a deficiency of intrinsic factor, lack of ability to absorb vitamin B12 and therefore poor availability of cobalamin (vitamin B12)

The Food and Drug Administration (FDA) recommends people who have a personal or family history of medullary thyroid cancer (MTC) should not use Zepbound along with people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

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The PPP reactions catalyzed by G6PD and the 6-phospho-gluconate dehydrogenase (EC 1.1.1.44) generate the reduced form of the pyridinic coenzyme nicotinamide adenine dinucleotide phosphate (NADPH)