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and (2) that making the stomach pump more effectively would inevitably lead to symptom improvement

doi: 10.1074/jbc.273.37.23625 44 CelesteD

Bad actors continue selling illicit tirzepatide made with substandard foreign ingredients despite the FDA warning that it puts Americans at heightened risk, and we continue to find critical safety and effectiveness issues in tirzepatide knockoffs, including bacterial contamination, high endotoxin levels and other impurities

Caution in individuals with eating disorders or very low BMI

107(6):771781 Endocrine and metabolic roles of insulin-like growth factor signaling in experimental models Sjgren K, Jansson JO, Isaksson OG, Ohlsson C., Minerva Endocrinologica , 2002

Basically, when you work out, especially during intense strength training, a component called acetyl CoA is produced in a large amount into the muscles, producing lactate and causing lactate buildup