GLP-1 receptor agonist compounded with B12 for smoother titration. 10mg/mL maximum-concentration formulation for advanced maintenance protocols.
At a glance:
Semaglutide
Synthetic 31-amino-acid analog of human GLP-1, modified for extended half-life via fatty acid conjugation that promotes albumin binding. Selectively binds and activates the GLP-1 receptor, regulating glucose-dependent insulin secretion, gastric emptying, and central appetite signaling.
Methylcobalamin (Vitamin B12)
Active, methylated form of vitamin B12. Co-formulated with tirzepatide at 0.5mg/mL (1mg per 2mL vial) to support methylation pathways during dietary changes and to address fatigue commonly reported during GLP-1 titration. The B12 inclusion is compounding-specific and not present in FDA-approved tirzepatide products.
Mannitol
USP-grade bulking agent used during lyophilization. Produces a uniform cake, prevents peptide collapse during reconstitution, and has no pharmacologic activity at the doses used.
GLP-1 receptor activation
Selectively binds and activates the GLP-1 receptor in pancreatic β-cells, gut, and CNS. Triggers glucose-dependent insulin release, suppresses glucagon at hyperglycemic states, and slows gastric emptying — producing improved glycemic control and reduced food intake.
Central appetite regulation
Activates GLP-1 receptors in hypothalamic nuclei (POMC and AgRP neurons) and the brainstem. Reduces hunger, increases satiety after meals, and reduces "food noise" — the persistent, intrusive thoughts about food that many patients describe.
Glycemic control
Improves first-phase insulin response, reduces hepatic glucose output, and improves overall insulin sensitivity. STEP and SUSTAIN trial data show A1C reductions of 1.4 – 1.8 percentage points and meaningful weight loss across diabetic and non-diabetic populations.
Methylation support (B12)
Methylcobalamin supports the folate and homocysteine cycles, which become more relevant during rapid body composition change. The B12 component also addresses fatigue commonly reported during GLP-1 titration.
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