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Protocol 4: Post-menopausal metabolic restoration Goal: Address menopausal weight gain and metabolic changes Stack: Tirzepatide: Standard protocol (addresses insulin resistance) Tesamorelin: 1-2mg daily (visceral fat) CJC-1295/Ipamorelin: 200mcg each before bed (body composition, bone density) Resistance training: 3-4x per week Adequate protein and calcium Duration: 12+ months, potentially ongoing Expected results: 25-45 pounds weight loss Reduced visceral fat Improved insulin sensitivity Better body composition Maintained bone density Why this works: Addresses multiple menopausal factors - insulin resistance, visceral fat, muscle loss, bone density

No evidence of genotoxic activity was found in either assay

Cardiovascular data on endpoints like MACE-3 or MACE-4 are presently not available yet, but an early meta-analysis demonstrated at least cardiovascular safety in patients with T2D treated with tirzepatide (78, 79)

Canada is the standout country, notably a high GDP-per capita and a high exposure to OOP spend, as well as a substantial prevalence of adults living with obesity