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Coadministration of SGLT2 inhibitors and tirzepatide creates a synergistic risk for euglycemic ketoacidosis (EKA), a life-threatening condition characterized by ketone production and acidosis despite normal blood glucose levels.

If you are taking both an SGLT2 inhibitor (like empagliflozin) and tirzepatide, be aware that you are at risk for a rare but serious condition called euglycemic ketoacidosis (EKA). Unlike typical diabetic ketoacidosis, your blood sugar may remain normal, so do not rely on glucose readings alone. If you experience persistent nausea, vomiting, or extreme fatigue, seek medical attention immediately and ask for ketone testing, even if your blood sugar is not high.

Observational studies claiming GLP-1 receptor agonists reduce cancer risk are currently methodologically flawed and cannot support clinical policy due to high risk of bias.

Do not rely on current observational studies to claim that GLP-1 drugs prevent cancer. The existing data is methodologically flawed and cannot yet inform clinical practice or public health policy.

The presence of the rare BDNF p.Thr2Ile variant is associated with a suboptimal response to high-dose tirzepatide treatment, resulting in significantly less weight loss compared to clinical trial averages.

If you have the rare BDNF p.Thr2Ile variant, you might experience less weight loss from tirzepatide than the average patient. Discuss your genetic profile with your doctor to manage expectations and explore alternative treatments.

Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon, and phytotherapeutics are not recommended for insomnia treatment.

Avoid using antihistamines, antipsychotics, fast-release melatonin, ramelteon, or herbal supplements for treating insomnia, as they are not recommended by current guidelines.

Resmetirom is a recommended pharmacotherapy for adults with non-cirrhotic MASH and significant liver fibrosis (stage ≥2), demonstrating histological effectiveness on steatohepatitis and fibrosis.

If you have advanced liver scarring (fibrosis stage 2 or higher) but not cirrhosis, ask your doctor about resmetirom, a medication that can improve liver health.

Bariatric surgery is an option for individuals with MASLD and obesity.

If you have obesity and MASLD, discuss bariatric surgery with your doctor as a potential option to improve your liver health.

Caffeine consumption alters sleep architecture by increasing the duration and proportion of light sleep (N1) and decreasing the duration and proportion of deep sleep (N3/N4).

Even if you don't feel tired, caffeine may be stealing your deep sleep. Expect about 11 minutes less deep sleep and 6 minutes more light sleep per night if you consume caffeine close to bedtime. This reduces the restorative quality of your sleep, contributing to next-day fatigue.

Caffeine increases sleep onset latency by approximately 9 minutes and wake after sleep onset by approximately 12 minutes.

Caffeine makes it harder to fall asleep and stay asleep. Expect to take about 9 minutes longer to fall asleep and spend 12 minutes more awake during the night. This fragmentation reduces overall sleep efficiency by 7%.