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Anyone with a history of pancreatitis, serious stomach or gallbladder disease, or a family history of certain thyroid cancers needs especially careful medical review before using tirzepatide or semaglutide, since both drugs affect gut hormones and digestion, and people on insulin or sulfonylureas must watch for low blood sugar, while those with significant kidney disease or severe gastrointestinal symptoms may need slower titration, alternative medications, or more frequent monitoring, so an honest conversation with an experienced prescriber and a full medication list is critical before starting or switching

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