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Protocols recommend an initial loading phase of 22.5 mg twice weekly for 46 weeks, followed by a maintenance dose of 22.5 mg every 12 weeks
The mechanism is generally telogen effluvium driven by rapid weight loss rather than a direct effect of tirzepatide, similar to what is seen after bariatric surgery or any aggressive caloric deficit
The empty stomach requirement matters because food presence affects gastric pH and transit time
Avoid simultaneous use with strong acids or chelators (e.g., vitamin C or retinol serums) because they can inactivate copper peptides
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