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Sharp, angular media form large voids and remove less fine material than rounded media of equivalent size

Do Not Use Zepbound If You Have a personal or family history of medullary thyroid carcinoma Have Multiple Endocrine Neoplasia syndrome type 2 Have had a serious allergic reaction to tirzepatide or any of the ingredients in Zepbound Warnings and Precautions Severe gastrointestinal disease not recommended for patients with severe gastroparesis Acute pancreatitis Acute gallbladder disease Hypoglycemia with concomitant insulin or insulin secretagogue use Hypersensitivity reactions including anaphylaxis and angioedema Acute kidney injury Diabetic retinopathy complications in patients with a history of diabetic retinopathy Suicidal behavior and ideation monitor for new or worsening depression or unusual mood changes Pulmonary aspiration during general anesthesia or deep sedation delayed gastric emptying may increase aspiration risk Most Common Adverse Reactions Nausea, diarrhea, vomiting, constipation Abdominal pain and dyspepsia Injection site reactions Fatigue Hypersensitivity reactions Eructation, hair loss, gastroesophageal reflux disease Hormonal Contraception Interaction Zepbound may reduce the effectiveness of oral hormonal contraceptives
Mueller, C
Lancet 396 , 19791993 (2021)
Even the staunchest conventional physicians almost always recommend thyroid medication at this point

The only reason I put 4 with a plus is a somewhat long wait for the reception
