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My personal view is that this is a theoretical risk, and it will be low on my list of safety warnings for people in whom I initiate tirzepatide

Tirzepatide May Be a Better Fit If: Maximum weight loss is your primary goal, and tirzepatide consistently produces greater reductions in clinical data You have type 2 diabetes and want superior blood sugar control (SURPASS-2 showed clear superiority over semaglutide) You've tried semaglutide and plateaued, and the dual-agonist mechanism may produce additional response You respond well to lower doses, and tirzepatide 5mg matches semaglutide 2.4mg for weight loss Semaglutide May Be a Better Fit If: Cardiovascular protection is important, as the SELECT trial provides strong evidence for heart benefit You prefer an oral option: oral semaglutide exists (the Ozempic pill for diabetes, which reformulated and renamed Rybelsus in 2026, and the Wegovy pill for weight)

Retatrutide remains under clinical investigation, and combined use with MOTS-c is considered experimental

The 3 Is of immunity and aging: Immunosenescence, inflammaging, and immune resilience