The baseline panel Here is the complete list of tests to request before starting tirzepatide: Metabolic markers: Comprehensive metabolic panel (CMP), which includes glucose, electrolytes, BUN, creatinine, calcium, and liver enzymes Hemoglobin A1c (HbA1c), your 2-3 month blood sugar average Fasting insulin and fasting glucose HOMA-IR calculation (derived from fasting insulin and glucose) Lipid panel: Total cholesterol LDL cholesterol (direct measurement preferred) HDL cholesterol Triglycerides VLDL cholesterol Liver function: ALT (alanine aminotransferase) AST (aspartate aminotransferase) Alkaline phosphatase (ALP) Total bilirubin GGT (gamma-glutamyl transferase), optional but useful Kidney function: Serum creatinine Blood urea nitrogen (BUN) Estimated glomerular filtration rate (eGFR) Cystatin C (recommended for more accurate kidney assessment) Urine albumin-to-creatinine ratio (UACR), especially if diabetic Thyroid function: TSH (thyroid stimulating hormone) Free T4 Free T3 (optional but informative) Thyroid antibodies if history of thyroid disease Complete blood count (CBC): White blood cells, red blood cells, hemoglobin, hematocrit, platelets Differential (neutrophils, lymphocytes, monocytes, eosinophils, basophils) Additional recommended tests: Vitamin B12 (especially if taking tirzepatide with B12 ) Vitamin D Iron panel (ferritin, TIBC, serum iron) Magnesium Pancreatic enzymes (lipase, amylase), baseline reference This might seem like an extensive list

If you see particles, discoloration, or cloudiness, do not use that vial
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First, every patient developed symptoms specifically at the 2.4 mg dose
If using a powder product that requires reconstitution, prepare only what will be used within a reasonable timeframe