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If progressive motility is the main deficit, start with L-carnitine

Persistent plateaus despite dose optimization may indicate that your GIP pathway (engaged by tirzepatide but not semaglutide alone) holds the key to further progress

There appears to be a cumulative effect with repeated doses, so exceeding the tested doses risks unknown side effects

It was initially believed that it acts through inhibition of cyclooxygenase enzymes, similar to non-steroidal anti-inflammatory drugs (NSAIDs)

GLP-1(glucagon-like peptide 1) (Proglucagon) -1 L -1 -1 GLP-1

Concerns about colon cancer specifically have surfaced due to the theoretical consideration that GLP-1 receptors are present in various tissues, potentially including parts of the gastrointestinal tract