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Proton Pump Inhibitors (PPIs) Example: Omeprazole, Nexium, Prevacid Block stomach acid, which further reduces absorption of B12, magnesium, iron, and calcium Can worsen fatigue, muscle cramps, or brain fog Ask your provider whether long-term use is still necessary and monitor your nutrient levels regularly

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The downside is that you're layering tirzepatide's GIP effects on top of residual semaglutide (both have ~5-day half-lives, so semaglutide is still present for 2-3 weeks after your last dose)

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American Journal Of Clinical Dermatology, 14 (2), 147-153

Doucet E, Imbeault P, St-Pierre S, Almras N, Maurige P, Richard D, et al