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There are multiple ongoing trials assessing the benefit of PEG in HE

To understand the risk, we have to look at how Tirzepatide is built

According to Usman et al

Fluorescence-activated cell sorting (FACS) Request a detailed protocol Isolation of Shh + and Nfatc1+ cells for RNA-seq was performed using Shh- and Nfatc1-CreER::Rosa-stop-tdTomato::K14-H2BGFP mice

The analysis also identified additional symptoms that may warrant further investigation, including reproductive issues such as irregular menstrual cycles and temperature-related complaints such as chills and hot flashes

Hormones such as progesterone, estrogen, and testosterone can all contribute to insomnia especially in premenstrual women, pregnant women, and women in menopause but those problems are temporary and resolve once hormone levels return to normal