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preconception planning is important for patients with Hashimoto's disease [1] [2] Severe GI disease : Use caution or avoid in patients with severe gastrointestinal disease, including gastroparesis [1] Renal function : Monitor for dehydration and renal impairment if significant gastrointestinal adverse events occur Medication interactions : Do not use concurrently with other GLP-1 receptor agonists Patients with Hashimoto's disease considering tirzepatide should undergo comprehensive evaluation by an endocrinologist or physician experienced in managing both thyroid disorders and obesity pharmacotherapy

Skibicka KP (2013) The central GLP-1: implications for food and drug reward

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Confusing the two is the most common way to under- or over-draw