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B6 is especially important for GABA/dopamine and B12/folate for mood and cognition
Small molecules like nitroglycerin (molecular weight 227 daltons) absorb sublingually with excellent efficiency
However, simultaneous initiation is acceptable in motivated patients requiring rapid glycaemic improvement
Women in this category often do best with Protocol 1 (the gentle start) with an additional modification: extending each dose level by one to two weeks during periods of noticeable hormonal fluctuation
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Additionally, tirzepatide suppresses glucagon secretion, slows gastric emptying, and promotes satiety, which contributes to weight lossa beneficial effect for many patients with type 2 diabetes
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