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These include the POMC-derived peptides released by neighbouring keratinocytes and the neuropeptide calcitonin gene-related peptide, substance P, and neuropeptide Y released from intramucosal free nerve endings, which are in close contact with melanocytes in the basal cell layer of the epithelium
Tirzepatide can affect sleep quality , particularly during dose changes, which creates a vulnerability window for autoimmune patients
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If additional support is needed, increase to 150 mg three times daily
This is particularly relevant for men taking oral medications for blood pressure, thyroid conditions, or diabetes
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