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2011 Oct 1;18(29):4454-69

If you are worried the shot will be painful you can rest assured that most clients find the discomfort negligible

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And the GH increase supports better sleep, faster recovery, and improved mood alongside the fat loss

The mechanism is generally telogen effluvium driven by rapid weight loss rather than a direct effect of tirzepatide, similar to what is seen after bariatric surgery or any aggressive caloric deficit