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You would simply be adding levocarnitine to your existing tirzepatide protocol

Once first used, Ozempic pens can be stored at room temperature (below 30C) or in a refrigerator (2C to 8C) for up to 6 weeks (42 days), after which they must be discarded even if some medication remains

The Role of Leptin and Ghrelin in the Regulation of Food Intake and Body Weight in Humans: A Review. Obesity Reviews , vol

Tirzepatide's simultaneous GIPR and GLP-1R engagement generates two spatially distinct cAMP pools that converge on EPAC2, producing a larger net insulin secretory response than single-receptor stimulation at equivalent total cAMP levels [18]