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Single and dual agonists The fundamental difference between these two molecules is that semaglutide is a GLP-1 agonist, i.e., it has a strong structural similarity (95%) with this hormone and specifically activates its receptor, while tirzepatide is a dual agonist, i.e., it has a hybrid structure that allows it to activate both GLP-1 and GIP receptors (Figure 2)

One additional consideration for people on intensive protocols: nausea and reduced fluid intake can sometimes concentrate urine, potentially creating a dilute-adjacent profile that testing sites may flag as a low-validity specimen

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