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It is not known if compounded tirzepatide will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people

Ni H, Chen L, Song L, Sun L, Cui H, Zhou Q, et al

Whether combinations produce additive or synergistic effects across the gene-expression pathways modulated by GHK-Cu remains an open research question [12]

doi: 10.1007/s12011-023-03616-0 27 DaragAKlimczakMStragierowiczJStasikowska-KanickaOKilanowiczA

Natural GLP-1 has several effects: Insulin stimulation: GLP-1 signals the pancreas to release insulin, but only when blood sugar is elevated

The article says DPP-4 inhibitors carry a small risk of joint pain and rare reports of severe infections, and it flags severe renal impairment, citing an eGFR below 15 for some DPP-4 agents, as a caution