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If recent lab work is not available, we may order a baseline panel before proceeding
Cycle Duration and Monitoring Typical cycle: 1224 weeks Monitoring: baseline and 1012 week IGF-1 measurement is the most common biomarker Washout: 48 weeks between cycles is standard practitioner practice Contraindications Active malignancy GH/IGF-1 axis elevation is a theoretical oncogenic concern Diabetes mellitus GH elevates insulin resistance
While Vitamin B12 is a naturally occurring nutrient that is generally considered very safe even in high doses, it is still a medical treatment
This transition is planned over 12 weeks, allowing semaglutide to clear while tirzepatide dosing begins at the lowest tier, then escalates slowly
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