Safety of Tirzepatide with NAD and Vitamin B12 Supplements
There are no known contraindications or clinically significant drug interactions between tirzepatide and either NAD or vitamin B12 supplements, making this combination safe to use together.
Evidence Base and Rationale
The available clinical evidence does not identify any safety concerns with this combination:
No documented interactions exist between tirzepatide and NAD or vitamin B12 in the extensive SURPASS clinical trial program (SURPASS 1-5), which enrolled thousands of patients over treatment periods up to 104 weeks 1, 2.
Tirzepatide's mechanism of action as a dual GIP/GLP-1 receptor agonist does not interfere with NAD metabolism or vitamin B12 absorption pathways 1, 3.
The safety profile of tirzepatide is well-established, with adverse events primarily gastrointestinal (nausea, vomiting, diarrhea, constipation) rather than metabolic interactions with supplements 4, 2.
Clinical Considerations
Vitamin B12 Monitoring
If you are taking metformin concurrently with tirzepatide, vitamin B12 supplementation is actually beneficial, as metformin can reduce B12 absorption over time 5.
No special monitoring is required for the tirzepatide-B12 combination itself, though routine B12 levels may be appropriate if metformin is part of the regimen 5.
NAD Supplementation
NAD supplements have no documented interactions with glucose-lowering medications in the current literature.
Continue standard monitoring for tirzepatide therapy (glucose levels, weight, gastrointestinal symptoms) regardless of NAD supplementation 6, 2.
Important Safety Notes
Tirzepatide-Specific Precautions
Hypoglycemia risk increases when tirzepatide is combined with insulin or sulfonylureas, but not with NAD or B12 supplements 6.
Gastrointestinal side effects (nausea, diarrhea) occur in 12-17% of patients on tirzepatide and are dose-dependent, but are not exacerbated by vitamin supplementation 4, 2.