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One of the most severe is gastroparesis
Kathryn Horton, a board-certified internal medicine physician, stated it directly: "Tirzepatide is a synthetic peptide that is rapidly degraded by digestive enzymes within the gastrointestinal tract." The larger molecular size and chemical modifications that enable dual-receptor agonism "currently pose significant challenges for the development of an effective oral formulation." For sublingual delivery specifically, the absorption story is slightly different but still problematic
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Wu Q, Palmiter RD
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