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Your body is learning to function without the constant spikes of glucose it may have relied on for years

But things changed quickly: Eli Lilly, the manufacturer of Mounjaro (tirzepatide), increased supply, and the FDA declared the shortage over

These mechanisms evolved to protect against starvation but become problematic in environments of food abundance

The FDA set transition periods: 503A compounding pharmacies could continue compounding tirzepatide through specified deadlines, and 503B outsourcing facilities had slightly longer windows

First characterized in the open scientific literature in 2018 (Coskun et al.)