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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

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Randomization is essential to avoid selection bias and ensure that the treatment groups are comparable

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That is plausible in the context of small effects seen in human studies: Lcarnitine can add a modest nudge when combined with consistent training and sensible eating

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