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Together with IL-3, IGF-I stimulates differentiation and proliferation of myeloid cells and has been shown to regulate lymphopoiesis by stimulating proliferation and differentiation of T and B cells in lymphoid organs (Heemskerk et al.)

Missing doses or stopping the medication regularly can also reduce effectiveness

Those same actions especially the slowed stomach emptying are what drive nausea, and the gut adapts to them only gradually

Sources Eli Lilly press release: Lilly's triple agonist, retatrutide, successful in two additional Phase 3 obesity trials, delivering significant improvements in weight and A1C

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