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It binds to c-Met, activates intracellular signaling, upregulates synaptic machinery, and triggers gene transcription changes that continue autonomously once initiated

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Constipation is less dose-dependent and can persist, making it a more durable reason for discontinuation in patient reports. Sulfur burps reflect food sitting longer in a slowed stomach. Fatigue ranks second only to nausea in patient forums, although much of it tracks the calorie deficit rather than tirzepatide itself. Fried or fatty foods, coffee, meat, and alcohol can also become less appealing