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The intermediates from de novo lipogenesis in the liver will disrupt mitochondrial function and produce ROS, and then cause endoplasmic reticulum (ER) stress, ultimately leading to inflammation, and the broken cells releasing cytokines will cause more cell death ( The excess free fatty acids (FFAs) and de novo lipogenesis would break the homeostasis of lipid metabolism

Still, it sometimes becomes challenging for people taking Ozempic because their appetite is so low or they are dealing with digestive side effects

P., Zeidler, C

Traditional compounding is still commonplace today, see 353a, and theoretically a patient could be allergic to an ingredient in Zepbound and require compounded tirzepatide instead

The primary risks include bile duct stones or obstruction, compounded gastrointestinal side effects (nausea, diarrhoea), and pancreatitis