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Uninsured costs range from the mid-hundreds to low thousands per month Tirzepatide GLP-1 & GIP dual receptor agonist : (as semaglutide, plus fat metabolism, insulin sensitivity, and enhanced satiety) SURMOUNT 1 20.9% (72 weeks) SURMOUNT 5 (40 weeks, BMI 40): -20.2% ~2021% average loss 20% loss in ~36% of users 25% in ~25% (up to 40% in SURMOUNT-3) 15mg weekly Nausea (52%) Diarrhea (33%) Vomiting (25%) Constipation (25%) Higher rate of initial GI symptoms vs

Concurrently, persistent elevation of fibroblast growth FGF23 not only downregulates CYP27B1 but also induces the catabolic enzyme CYP24A1, accelerating the degradation of active vitamin D and further impairing its biological activity (13)

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