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Metformin (Glucophage) and topiramate (Topamax) are commonly used and relatively safe

Tirzepatide takes about a month to build up in your system, and people may not reach their full maintenance dose until around week 21

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Altern Med Rev 1998

The article says deficiency develops insidiously, and that early symptoms such as fatigue or mood changes overlap with the experience of losing weight, which delays diagnosis

Zepbound is available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg doses