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This effect relates to increased metabolic activity from glucagon receptor stimulation

JIMD Rep 38:16

When prescribed and administered appropriately, peptide therapy can decrease inflammation, encourage weight loss, and combat age-related fatigue

Classification of hepatic encephalopathy The clinical presentation of HE may be highly variable constituting, a myriad of signs and symptoms ranging from defects in cognition, personality and intellect to altered conscious state and impaired neuromuscular function such as asterixis and hyperreflexia

If you lack vitamin B12, which is essential for producing blood cells and skin health, it can cause upper lip pigmentation[9]

We find this to be precisely the problem that TMLHE mutations created in mice