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Explosive Zepbound diarrhea, especially when paired with vomiting, fever, or weakness, is the strongest red flag in the severity decoder

Tirzepatide with niacinamide Niacinamide (vitamin B3) is sometimes added because early research suggested it might reduce injection site reactions and potentially enhance peptide stability

This gentler introduction can strengthen treatment consistency, as side effect burden remains manageable throughout the early weeks

Wegovy and tirzepatide medications mimic GLP-1 (glucagon-like peptide 1), but tirzepatide also mimics GIP