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Sequential versus simultaneous initiation : Many clinicians prefer establishing tirzepatide tolerance and efficacy before adding other therapies, allowing clearer attribution of benefits and adverse effects

[DOI] [PubMed] [Google Scholar] 33.Meredith MJ, Cusick CL, Soltaninassab S, Sekhar KS, Lu S, Freeman ML

Further reports of this variant in individuals with a similar phenotype may allow for this to be upgraded to a likely pathogenic variant according to ACMG guidelines

Thats exactly why medical supervision matters, and why gray-market use by older men with unscreened cardiac risk is dangerous