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Current clinical guidance suggests that tirzepatide can be continued indefinitely for appropriate candidates, similar to how patients manage chronic conditions like blood pressure or cholesterol

This is usually not enough to cause significant degradation over the life of a single vial, but combined with other stress factors, it contributes

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These symptoms occur because excess glutathione can increase glutamate levels (an excitatory neurotransmitter)

Peer review Peer review information Nature Medicine thanks Christiana Kartsonaki, Naveed Sattar and the other, anonymous, reviewer(s) for their contribution to the peer review of this work