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The theoretical concern remains exactly that
There is an enhanced effect of corticosteroids in patients with hypothyroidism and in those with cirrhosis
Research published in JCI Insight describes tirzepatide as an "imbalanced and biased" dual agonist, meaning it shows equal affinity for the GIP receptor compared to native GIP but approximately 5-fold weaker affinity for the GLP-1 receptor compared to native GLP-1
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