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please double check what your iron level actually is as low iron can cause palpitations which it sounds like from your description are long standing and were concerning enough to warrant specialist referral- a normal lab range for iron can vary from area to area, for example, it could be quoted as normal and be as low as 10

For example: IGF-1 LR3 : ~2030 hours CJC-1295 with DAC : 58 days GHRP-6 : ~1560 minutes BPC-157 : Rapid local action with unclear systemic half-life Peptides modified to increase half-life such as PEGylation , glycosylation , or fatty acid acylation are specifically engineered to resist enzymatic degradation and improve duration of action

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The gastric emptying effectwhich can impact B12 absorptionoccurs regardless of whether your tirzepatide comes from a compounding pharmacy or a manufacturer