21 posts in this category, sorted most recent first.
Most coverage of tirzepatide treats it as a weight-loss drug. For T2D patients, the dose ramp, dosing goal, comparison frame, and what success looks like are all different.
Lifting consistently while on tirzepatide is the single most actionable thing you can do for body composition outcomes. Specific exercises, sets, frequency, and timing relative to dose.
Most first-visit conversations get rushed because the patient isn't prepared and the clinician has 12 minutes. Here's the prep list that makes the appointment actually useful.
The window for catching a missed weekly dose is wider than most patient handouts say. Here's what actually matters and how to think about getting back on cycle.
Semaglutide is sold under four brand names with three different routes of administration and shifting region-by-region availability. Here's the complete index of Panya coverage, organized by what you're trying to figure out.
Most clinics either keep you at maintenance dose forever or have you stop cold turkey. The middle path, a structured taper, is more workable than either, but the protocol isn't standardized. Here's what's known.
Tirzepatide has been the most-asked-about drug in the Panya inbox for two years. Here's the entire blog catalog on it, organized by the question you're actually trying to answer.
Constipation is the second most common tirzepatide side effect after nausea, and unlike nausea it doesn't fade on its own. Here's the protocol that actually works.
Local rash at the injection site is one of the more common but rarely-discussed tirzepatide side effects. Most cases are minor and resolve. The few that don't follow a predictable pattern.
Pen technique gets twenty seconds at the prescription appointment. The patient handouts say 'rotate sites'. There's more to it, and a few of the details affect whether week one is rough or smooth.
About 15-20% of patients respond poorly to tirzepatide. Most cases are workflow problems with fixable causes. Here's the diagnostic decision tree.
Most clinics tell you to 'eat more protein' on tirzepatide. The number you actually need is higher than baseline guidelines suggest, and the timing matters more than the total.
Resmetirom is the only approved MASH drug today. Survodutide just read out phase 3 obesity at 16.6%; LIVERAGE + LIVERAGE-Cirrhosis pending. Pemvidutide IMPACT-MASH starting phase 3 H2 2026. Why we hold on MASH-specific routing recommendations and what we'd need to see to start.
The patient handouts give you a list of possible side effects. They don't tell you the timeline. Here's the day-by-day version most clinics don't write down.
The mistake most people make on the switch is treating it like upgrading a phone. The drugs work on different receptor mixes and the body needs a beat to recalibrate. Here's how to do it without the rebound.
What actually shifted in the last 60 days: Foundayo (orforglipron) approved early under the National Priority Voucher, oral Wegovy 25mg shipping, FDA proposes excluding tirzepatide from 503B bulks, RFK pulled 14 peptides off Category 2, survodutide phase 3 obesity readout. Routing impact for each.
Eli Lilly's triple agonist (GLP-1 + GIP + glucagon) has TRIUMPH-1, TRIUMPH-2, and TRIUMPH-4 readouts in the public record. Weight reduction at 12mg lands above tirzepatide. Cardiovascular signal is being watched. FDA filing window now points at late 2026. What this changes in routing decisions today.
The dose-step decisions most people get wrong on tirzepatide. When to stay at 5mg, when to push to 10mg, what gastrointestinal side effects actually tell you, and the muscle-loss + protein math nobody mentions until it bites.
Retatrutide, orforglipron, CagriSema, survodutide, MariTide, pemvidutide. Where each one sits in phase 3, the readout window, the mechanism, and what each approval would shift for routing decisions today. Bleeding edge of the science, conservative on the rating.
What actually happens when you start tirzepatide. What is common, what is rare, what is serious, what to do about each.
Same drug class, different receptor profile. Here is the honest comparison, without the marketing gloss.