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doi: 10.1016/j.cell.2016.05.044
They show deference to your doctor expertise while also establishing that you expect a thorough evaluation
There is no official contraindication to using tirzepatide and sermorelin concurrently, but there is also limited clinical evidence specifically evaluating this combination

Some patients experience mild jitteriness during dose escalation that resolves within days, while others report persistent low-grade worry or panic sensations