does dpp 4 break down glp-1 DPP4 degrade the GLP1 and incretion, which leads to suppression of the Inhibition of DPP-4. Food consumption

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Nat Struct Biol 6:359365 Holmes MV, Newcombe P, Hubacek JA, Sofat R, Ricketts SL, Cooper J et al (2001) Effect modification by population dietary folate on the association between MTHFR genotype, homocysteine, and stroke risk: a meta-analysis of genetic studies and randomised trials

Contraindications: As per the US licence, I would regard tirzepatide as contraindicated in people with a personal or family history of medullary thyroid carcinoma (MTC) and in those with multiple endocrine neoplasia syndrome type 2 (MEN 2)

probiotics add new, good bacterial strains to the mix

You'll have a clear starting protocol, realistic timelines, and a follow-up at 4 to 6 weeks to assess your response and adjust as needed