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First approved dual GIP/ GLP-1 receptor agonist tirzepatide (Mounjaro) added to guidelines Stimulates incretin effect, promoting insulin secretion and glucose clearance after meals Rated very high efficacy for A1C% and weight reduction Cardiorenal benefit currently under investigation Subcutaneous injection administered once weekly Gastrointestinal adverse effects may occur initially and decrease over time See Section 9

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Those with kidney disease, previous kidney stones, or eye conditions face heightened risk and require baseline kidney and ophthalmology evaluation before attempting combination therapy

Endocrine Support (CJC1295, Ipamorelin banned for NCAA) These help reinforce the natural pulsatile rhythm of growth hormone release the system responsible for nighttime recovery, tissue rebuilding, cellular regeneration, and body composition

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