Marshall's very soft
Symptoms of such an extreme over-dose can include increased fatigue, joint or muscle pain, skin rashes, photosensitivity, irritability, paresthesia, dizziness, sleep disturbances, asthenia, muscle cramps, night sweats, hypertension, hypotension, headaches (especially migraines) and swollen glands
The American Peptide Society summarized these concerns bluntly, noting that limited detail and missing sequence information make the original work difficult to reproduce (American Peptide Society)

TIER PLANS TIER 0 (20mg total) $295 total for 10 week supply Monthly cost breakdown: $118 Recommended if using low (or micro) doses of 2mg/week or less TIER 1 (40mg total) $350 total for 8-10 week supply Monthly cost breakdown: $140-$175 based on weekly dose Recommended if new to treatment or for those on 2-5mg/week TIER 2 (60mg total) $395 total for 8-10 week supply Monthly cost breakdown: $158-$197 based on weekly dose Recommended for those on 6-7mg/week TIER 3 (80mg total) $495 total for 8-10 week supply Monthly cost breakdown: $198-$247 based on weekly dose Recommended for those on 8-10mg/week TIER 4 (120mg total) $645 total for 8-10 week supply Monthly cost breakdown: $258-$322 based on weekly dose Recommended for those on 11mg/week and up MONTHLY PLANS Monthly Starter Dose $175 total for one month supply Recommended if new to treatment or for those on doses of 2.5mg/week or less Monthly Mid Dose $245 total for one month supply Recommended for doses up to 7.5mg/week Monthly Advanced Dose $275 total for one month supply Recommended for doses of 7.5-10mg/week Monthly Advanced Plus Dose $335 total for one month supply Recommended for doses of 11mg/week and up OptioRX Pharmacy - Tirzepatide/Niacinamide Injection Up to 90 days BUD

19.1% reported depression at any point between baseline and LT-FU and 48.3% scored above thresholds for abnormal fatigue
Offer Safer Alternatives Within Your Scope Figure out what the patient actually wants to achieve