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Vital signs including blood pressure, heart rate, and body temperature remained stable

Hopper et al., 2004), several other lines of evidence support an inhibitory role for NO-mediated modifications at the NMDA receptor (Manzoni et al., 1992

Instead of asking 'why not stack them,' the question becomes 'what specific outcome justifies adding a second compound with incomplete human safety data?' For research exploring maximal metabolic intervention where single-agent tirzepatide has plateaued, the stack may be defensible

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This does not mean complete abstinence is required, but regular alcohol consumption will substantially reduce protocol effectiveness