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But it has not been ruled out, and the FDA's briefing documents noted it as an uncharacterized risk requiring further investigation before any approval

So clearly there is something else going on

The sites research-use references are the Tirzepatide 5 mg vial dosage reference and the Tirzepatide 10 mg vial reference, and the titration logic is covered in the tirzepatide dosage titration overview

The DPPIV enzyme defect is linked to abnormal peptide content in the urine of children with autism and is believed to be associated with the disorder

Peptides do not have equivalent human evidence

It tracks closely with the metabolic deterioration that characterizes the third and fourth decades of life: rising fasting insulin, expanding visceral adipose tissue, declining mitochondrial density in skeletal muscle, and blunted exercise adaptability