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Current evidence does not support permanent hair follicle damage from these medications, and most reported cases describe temporary shedding with eventual regrowth

The gastrointestinal side effects result primarily from delayed gastric emptying and altered gut motility

Shortcuts or skipping steps can trigger nausea, cramps, or dizziness

Inadequate protein intake, reduced physical activity, and dehydration may also contribute

Semaglutide pens may have different needle gauges than tirzepatide pens, and compounded formulations of each may have different volumes for equivalent doses

Our review was based on a systematic PubMed search of randomized controlled trials (RCTs), observational studies, systematic reviews/meta-analyses, literature reviews, and case reports, published up to 2022, evaluating the combined treatment with a GLP-1RA and a SGLT2i in T2DM or prediabetes