Best for: Patients who want proven GLP-1 appetite suppression with the most extensively studied safety profile at various dose levels
My general framework: Start with semaglutide if cost is a significant concern, or if there is no strong reason to expect poor tolerance Start with tirzepatide if the patient has tried semaglutide before and struggled with side effects, if faster initial response matters clinically, or if the patients goals require larger total weight loss Switch to tirzepatide if a patient on semaglutide is experiencing persistent nausea or has plateaued and escalation options are limited One pattern worth noting: men I see a consistent pattern with male patients who struggle to tolerate semaglutide nausea and GI disruption can be particularly disruptive for them, and theyre often less willing to push through it
Lyophilized (freeze-dried) BPC-157 and TB-500 should be stored in a cool, dry place away from direct light ideally refrigerated at 2 to 8 degrees Celsius
Novo Nordisk, the pharmaceutical company that currently produces FDA-approved semaglutide products, including Ozempic, does not sell semaglutide for compounding
Life was good
The challenge is that once you realize it's gone, rebuilding it is usually much harder than preserving it in the first place