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Physical examination may reveal pallor, glossitis, neurological signs such as reduced vibration sense or proprioception, and in advanced cases, ataxia or cognitive impairment

The evidence for this mechanism is less robust than the VEGF/angiogenesis or gut-lining signalling pathways, and it is typically characterised as a secondary or tertiary mechanism in BPC-157 research rather than a primary research focus

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However, tirzepatide tends to produce different side effect patterns than semaglutide, so be prepared to reassess during your first few weeks if the side effect timing does not match what you experienced before

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