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In the research community, sustained or supraphysiologic IGF-1 exposure is associated with progressive abdominal distension (sometimes called 'GH gut') and concern for cardiac hypertrophy

For those exploring the full range of tirzepatide alternatives , newer compounds like retatrutide , survodutide , mazdutide , and CagriSema are in various stages of development and may offer additional options in the future

If it has degraded more, you are still underdosing

Healthy subjects in this phase 1 study who were given a 225 mg dose had a mean concentration of 22.1 g/mL at day 29 and those given 675 mg had a mean concentration of 24.1 g/mL at day 85