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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

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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

The first time you drink recycled water, the logical part of your brain is telling you how safe it is, and theres another part thinking about where the water came from