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277 (Pt 2): R582R590

Dose increases: Symptoms often return temporarily with each dose increase, then subside within 1 to 2 weeks

A taper reverses this ladder over a similar 20-to-24-week window: Weeks 1 to 4: reduce to 12.5 mg weekly Weeks 5 to 8: reduce to 10 mg weekly Weeks 9 to 12: reduce to 7.5 mg weekly Weeks 13 to 16: reduce to 5 mg weekly Weeks 17 to 20: reduce to 2.5 mg weekly Week 21: discontinue, or evaluate ongoing need at 2.5 mg The SURMOUNT-3 trial (N=579) showed that patients who completed an intensive lifestyle intervention before starting tirzepatide lost an additional 18.4% on-drug [9]

Its this level of precision that separates amateur work from professional, publication-worthy science

Common causes include stress, caffeine, dehydration, or exercise