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Adding cagrilintide to tirzepatide Theoretical protocol (not clinically studied): If on tirzepatide 10-15mg: Stable on tirzepatide for 4+ weeks Continue tirzepatide at current dose Add cagrilintide 0.6mg weekly Standard cagrilintide titration to 2.4mg Rationale: Tirzepatide is dual GIP/GLP-1 (very powerful alone) Adding amylin pathway could theoretically enhance No clinical data on this combination Uncertain if additional benefit over tirzepatide alone Concerns: GI side effects may be severe (both slow gastric emptying) Tirzepatide already produces 15-22% weight loss alone Unclear if cagrilintide adds meaningful benefit Expensive combination Verdict: Wait for clinical data

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Romero-Alemn Mdel M, Monzn-Mayor M, Santos E, Yanes CM (2013) Regrowth of transected retinal ganglion cell axons despite persistent astrogliosis in the lizard (Gallotia galloti)

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Efficacy of probiotics on cognition, and biomarkers of inflammation and oxidative stress in adults with Alzheimers disease or mild cognitive impairment - a meta-analysis of randomized controlled trials