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Arora says

A smaller dose does not neutralize risk in patients with conditions such as medullary thyroid carcinoma history, MEN2, pancreatitis, gastroparesis, or pregnancy

combined with the impact of gastrointestinal reactions on the absorption and adherence of oral contraceptives, the risk is further amplified, particularly during the initiation or dose-escalation phases of tirzepatide (161, 162, 169)

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Others report their taste buds feeling dulled