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When tissue folate and cobalamin stores are intact, an abnormal increment of postmethionine-load homocysteinemia may also reveal a saturation of the transsulfuration pathway caused by dietary methionine excess that might be combined with transsulfuration defects (in cases with basal hyperhomocysteinemia) or with the homozygous thermolabile MTHFR defect (in cases with normal fasting homocysteine) (Cattaneo, 1999)

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The article points to patients with mobility limitations, severe obesity, cardiopulmonary comorbidities or arthritis, who it says may begin with GLP-1 monotherapy under provider supervision to reduce injury risk and build initial confidence

However, the clinical difference in systemic delivery is significant

Certain health conditions can impact the weight loss results achieved with tirzepatide