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Simple timing framework Baseline Discuss baseline review before starting, especially with high blood pressure, arrhythmia, anxiety, stimulant use, antidepressants, diabetes, or cardiovascular disease

Avoid foods high in fat, as fat slows gastric emptying and semaglutide already slows gastric emptying, meaning the combination can create prolonged discomfort

Simultaneously, tirzepatide suppresses inappropriate glucagon secretion from pancreatic alpha cells, which helps prevent excessive hepatic glucose production

These include: Neurological symptoms : tingling or numbness in hands and feet (peripheral neuropathy), difficulty walking or balance problems, memory difficulties, or mood changes including depression Haematological signs : persistent fatigue, weakness, pale or jaundiced skin, or shortness of breath Glossitis : a sore, red, smooth tongue Cognitive symptoms : difficulty concentrating, confusion, or "brain fog" Seek urgent medical attention if you experience rapidly worsening neurological symptoms, significant difficulty walking, severe paraesthesia, or marked cognitive decline, as these may require immediate assessment