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Contact my clinic to book your appointment with me, and Ill be happy to look at your case, and recommend treatments that will best suit your needs

However, as with any active ingredient, patch testing is advisable

Methylcobalamin should not be used in patients with early hereditary optic nerve atrophy (Lebers disease)

Adding cagrilintide to tirzepatide Theoretical protocol (not clinically studied): If on tirzepatide 10-15mg: Stable on tirzepatide for 4+ weeks Continue tirzepatide at current dose Add cagrilintide 0.6mg weekly Standard cagrilintide titration to 2.4mg Rationale: Tirzepatide is dual GIP/GLP-1 (very powerful alone) Adding amylin pathway could theoretically enhance No clinical data on this combination Uncertain if additional benefit over tirzepatide alone Concerns: GI side effects may be severe (both slow gastric emptying) Tirzepatide already produces 15-22% weight loss alone Unclear if cagrilintide adds meaningful benefit Expensive combination Verdict: Wait for clinical data

Therefore, two may be better than one in this case, but do what's best for you