Myalgic encephalomyelitis: international consensus criteria
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The interest in tendon recovery is backed by preclinical work such as this study examining how BPC-157 influences tendon fibroblast healing and growth factor expression in injured connective tissue
The good news is that a lack of weight loss doesnt necessarily mean tirzepatide isnt working
Advise them to immediately discontinue the drug and to inform their healthcare provider at the first sign of a skin rash, hives or other skin reactions, difficulty in swallowing or breathing, any swelling suggesting angioedema (for example, swelling of the lips, tongue, face, tightness of the throat, hoarseness), or other symptoms of an allergic reaction [see Warnings and Precautions (5.2)]
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Conservative combination protocol (if attempting) Rationale for conservative approach: No safety data available Both peptides slow gastric emptying significantly Risk of severe GI complications Start low, go slow principle Tirzepatide component: Follow standard FDA-approved titration Weeks 1-4: 2.5mg weekly Weeks 5-8: 5mg weekly Weeks 9-12: 7.5mg weekly Weeks 13-16: 10mg weekly Week 17+: 12.5mg weekly (or stay at 10mg) Some reach 15mg weekly (maximum) Cagrilintide component (reduced from standard): Start AFTER tirzepatide stabilized at therapeutic dose (week 13+) Week 13-16: 0.6mg weekly (lower than standard) Week 17-20: 1.2mg weekly Week 21-24: 1.8mg weekly (may be maximum tolerable) Consider 2.4mg only if tolerating perfectly Conservative dosing comparison: Why sequential is safer: Tirzepatide establishes baseline first Can attribute new side effects to cagrilintide Easier to manage one variable at a time Option to stop cagrilintide if intolerable Less overwhelming than both simultaneously Expected benefits: 18-25% total weight loss (conservative estimate) Potentially superior to tirzepatide alone (15-22%) But incremental benefit may be modest (3-5% additional) Use SeekPeptides to plan sequential peptide additions safely
