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I am not given up my *affiliated* PCP over this, which is why I am trying the endocrinology route
Tirzepatide is initiated at 2.5 mg subcutaneously once weekly for 4 weeks as a starting dose to improve gastrointestinal tolerability, then gradually titrated every 4 weeks up to a maximum of 15 mg weekly based on therapeutic response and tolerability
Some of these like ashwagandha have limited evidence for lowering perceived stress or cortisol in certain studies 2
It is now widely accepted that oxidative stress can lead to changes in the expression of specific genes including renal injury-related genes, like kidney injury molecule 1 (KIM-1), tumor necrosis factor alpha (TNF-), and Neutrophil gelatinase-associated lipocalin protein (NGAL) [15]
Moreover, systemic activation of PPAR increases food intake and body weight in rodents 8 and neuron-specific deletion of PPAR decreases body weight and food intake in mice fed a high-fat diet 9