Revolutionary Dual-Action Treatment for Weight Loss

Tirzepatide, marketed under the name Mounjaro, is a once-weekly injectable medication approved for the treatment of type 2 diabetes and used off-label for weight management. It functions as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, mimicking the effects of natural incretin hormones to enhance insulin secretion, reduce appetite, and support metabolic regulation. While Tirzepatide has demonstrated significant efficacy in weight loss and glycemic control, it is associated with a range of adverse effects that must be carefully considered.

The most commonly reported side effects of Tirzepatide include gastrointestinal symptoms such as nausea, vomiting, diarrhea, constipation, and decreased appetite. These effects tend to occur during the early stages of treatment and are generally mild to moderate in severity. According to the prescribing information approved by the U.S. Food and Drug Administration (FDA), these side effects are typically transient and improve over time, especially when patients initiate therapy at a lower dose and increase it gradually [FDA, 2022].

More serious but less common adverse effects include acute pancreatitis. Cases of both fatal and non-fatal pancreatitis have been reported in patients using GLP-1 receptor agonists, including Tirzepatide. Clinical signs such as persistent severe abdominal pain, often radiating to the back and accompanied by vomiting, should prompt immediate medical evaluation and discontinuation of the drug if pancreatitis is confirmed [FDA, 2022].

Tirzepatide carries a boxed warning regarding the risk of thyroid C-cell tumors, which were observed in rodent studies. Although it is unknown whether the drug causes such tumors in humans, its use is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2). The warning is consistent with those found in other GLP-1 receptor agonists due to shared mechanisms of action [Mayo Clinic Proceedings, 2022].

Hypoglycemia is not typically induced by Tirzepatide alone but may occur when the medication is used in combination with insulin or insulin secretagogues such as sulfonylureas. Clinical guidelines from the American Diabetes Association recommend adjusting the dosage of these concurrent therapies to minimize the risk of low blood sugar [American Diabetes Association, 2023].

Gallbladder-related events, including cholelithiasis (gallstones) and cholecystitis (inflammation of the gallbladder), have been reported in patients treated with Tirzepatide. While the mechanism is not fully understood, rapid weight loss is a known risk factor for gallstone formation. Patients should be monitored for symptoms such as upper abdominal pain, nausea, and jaundice [NIH, 2023].

Renal impairment, particularly acute kidney injury, has also been observed, often in the context of severe gastrointestinal side effects leading to dehydration. Patients with pre-existing kidney disease or those at risk for volume depletion should be closely monitored, and hydration should be emphasized during treatment, particularly when initiating or increasing doses [PubMed, 2022].

Another consideration is the drug’s impact on gastric motility. Like other incretin-based therapies, Tirzepatide delays gastric emptying, which can interfere with the absorption of orally administered medications that require rapid onset, such as oral contraceptives or certain antibiotics. Providers should evaluate potential interactions and consider alternative dosing schedules when necessary [FDA, 2022].

Lastly, rare cases of hypersensitivity reactions, including anaphylaxis and angioedema, have been reported. Patients experiencing signs such as rash, facial swelling, or difficulty breathing should discontinue the drug and seek emergency medical attention.

In conclusion, while Tirzepatide is a highly effective option for managing type 2 diabetes and supporting weight loss, it is not without risks. A thorough understanding of its side effect profile, along with appropriate patient selection and monitoring, is essential for maximizing benefits while minimizing harm. Patients should always consult with a licensed healthcare provider to determine whether Tirzepatide is appropriate for their individual health goals.

Vitamin B12 is known to be non-toxic even in high doses. The reported adverse reactions following parenteral administration of vitamin B12 include:

• Generalized: Anaphylaxis and death
• Cardiovascular: Pulmonary edema and congestive cardiac/heart failure during early treatment; peripheral vascular thrombosis
• Hematological: Polycythemia vera (a rare type of blood cancer)
• Gastrointestinal: Mild, transient diarrhea
• Dermatological: Itching; transitory exanthema (widespread skin rash)
• Miscellaneous: Feeling of swelling of entire body

References:

• U.S. Food and Drug Administration. (2022). Mounjaro (tirzepatide) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215866s000lbl.pdf
   
• Ghosal, S. (2022). Tirzepatide: a dual GIP/GLP-1 receptor agonist for type 2 diabetes. Mayo Clinic Proceedings, 97(11), 2189–2196. https://www.mayoclinicproceedings.org/article/S0025-6196(22)00666-1/fulltext
   
• American Diabetes Association. (2023). Standards of Care in Diabetes—2023. Diabetes Care, 46(Supplement 1): S1–S291. https://diabetesjournals.org/care/article/46/Supplement_1/S1/148328
   
• National Institutes of Health. (2023). Tirzepatide-associated gallbladder complications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462115/
   
• Marso, S. P., Bain, S. C., Consoli, A., et al. (2022). Safety and renal outcomes with GLP-1-based therapies. PubMed Central. https://pubmed.ncbi.nlm.nih.gov/35942080/

What is tirzepatide 

Tirzepatide General Information – Medivac Performance & Health

Tirzepatide, sold under the brand name Mounjaro, is a groundbreaking medication originally developed for the treatment of type 2 diabetes. It belongs to a new class of drugs known as dual incretin receptor agonists. Unlike traditional medications that target a single pathway, Tirzepatide activates both the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. These two gut-derived hormones play key roles in regulating blood sugar, insulin production, satiety, and metabolic balance. The dual action of Tirzepatide offers a more comprehensive approach to blood glucose control and weight management.

Tirzepatide works by enhancing the body's natural insulin response when blood sugar levels are elevated, while also reducing the amount of glucagon (a hormone that raises blood sugar) released by the liver. At the same time, it delays gastric emptying and suppresses appetite, which contributes to significant weight loss in many patients. These effects have made Tirzepatide an attractive option not only for managing diabetes but also for helping individuals with obesity or metabolic syndrome achieve lasting weight reduction.

In clinical trials, including the SURPASS and SURMOUNT studies, Tirzepatide has demonstrated superior results compared to existing GLP-1 receptor agonists such as semaglutide. Patients treated with Tirzepatide experienced notable reductions in hemoglobin A1c (HbA1c), fasting blood glucose, and total body weight—often reaching average weight losses of 15% to 22% depending on the dose and duration of treatment. These outcomes have positioned Tirzepatide as one of the most promising tools for metabolic health in recent years.

Tirzepatide is administered as a subcutaneous injection once weekly and is currently FDA-approved for the treatment of type 2 diabetes. While not yet officially approved for obesity treatment alone, it is commonly prescribed off-label for weight loss under the supervision of a licensed healthcare provider. The recommended starting dose is typically 2.5 mg once weekly, with gradual increases every four weeks up to a maximum of 15 mg, depending on tolerability and clinical response.

Like all medications, Tirzepatide carries some risk of side effects. The most common include gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation, particularly during the initial dose escalation phase. More serious but rare complications may include pancreatitis, thyroid tumors (as seen in animal studies), gallbladder disease, and kidney dysfunction. Because of these potential risks, it is important that Tirzepatide be prescribed and monitored by a qualified healthcare provider with experience in metabolic medicine.

At Medivac Performance & Health, we offer both brand-name and compounded versions of Tirzepatide as part of a personalized weight loss and metabolic optimization program. All patients undergo an in-depth consultation, lab evaluation, and customized treatment plan to ensure safe and effective use of this powerful therapy. Our integrative approach includes medical supervision, nutrition coaching, and fitness guidance to help patients achieve long-term success.

If you're struggling with weight, insulin resistance, or other metabolic concerns, Tirzepatide may be a transformative option. Contact us today to schedule your consultation and learn whether you're a candidate for treatment.

Cyanocobalamin is a vitamin of the B-complex family, commonly known as cobalamins (corrinoids). It is a synthetic or man-made form of vitamin B12 that is available as both a prescription and over-the-counter (OTC) medication. Cobalamins exist in several other chemical forms, including hydroxocobalamin, methylcobalamin, and adenosylcobalamin. Cyanocobalamin is the most common form of cobalamins used in nutritional supplements and fortified foods. It contains a cyano (cyanide) group in its structure, which makes it more stable than other forms of vitamin B12 as the cyanide stabilizes the molecule from deterioration. Hydroxocobalamin, however, is the most biologically active form of Vitamin B12; hence, it is more preferable than cyanocobalamin for the treatment of vitamin B12 deficiency.

Cyanocobalamin does not naturally exist in foods owing to the presence of cyanide, which is absent in the natural form of the vitamin. The chemical structure of cyanocobalamin contains the rare mineral cobalt (4.34%), which binds the cyano group and is located in the center of a corrin ring. The commercial manufacturing of the vitamin is done through bacterial fermentation. Compared to other forms of vitamin B12, it is easier to crystallize and more air-stable. Cyanocobalamin is usually obtained as a dark red, amorphous or crystalline powder, orthorhombic needles, or red crystals. The anhydrous form of the compound is highly hygroscopic. It may absorb up to 12% of water if exposed to air. Cyanocobalamin is sparingly soluble in alcohol and water (1 in 80 of water), but insoluble in chloroform, acetone, and ether. The coenzymes of this vitamin are highly unstable in light.

Cyanocobalamin is available in several dosage forms including the tablet, nasal spray, and injection. The US-FDA initially approved the drug in 1942. However, the compound became widely available for routine use in the treatment of B12 deficiency in the early 1950s.

The lack of vitamin B12 may result from any of the following conditions:

• Addisonian (pernicious) anemia — this condition causes autoantibody formation against parietal cells, which results in a lack of IF essential for absorption of vitamin B12 from the intestine
• Malabsorption — impaired absorption of vitamin B12
• Gastrointestinal pathology, dysfunction, or surgery — these include atrophic gastritis, celiac disease, small bowel bacterial overgrowth, pancreatic insufficiency, Helicobacter pylori infection, gastric carcinoma, and total or partial gastrectomy
• Diphyllobothrium latum and related species (the fish tapeworm) infestation — these parasites compete with vitamin B12 for intestinal absorption; this leads to a malabsorption of the vitamin
• Certain medications use — long term metformin use and chronic acid-reducing drugs decrease the absorption of vitamin B12 from food particles
• Malignancy of the pancreas or bowel
• Folic acid deficiency

References :

1. U.S. Food and Drug Administration. (2022). Mounjaro (tirzepatide) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215866s000lbl.pdf
    
2. Frias, J. P., et al. (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine, 385(6), 503–515. https://www.nejm.org/doi/full/10.1056/NEJMoa2107519
    
3. Jastreboff, A. M., et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine, 387(3), 205–216. https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
    
4. American Diabetes Association. (2023). Standards of Care in Diabetes—2023. https://diabetesjournals.org/care/article/46/Supplement_1/S1/148328
    
5. Mayo Clinic Proceedings. (2022). Clinical Use and Safety of Tirzepatide. https://www.mayoclinicproceedings.org/article/S0025-6196(22)00666-1/fulltext