For those participating in a clinical trial, all adverse effects even those that seem minor should be reported to the trial team as part of the pharmacovigilance process
Additionally, caloric restriction itself may contribute to cold sensitivity
The most frequent side effects are mild to moderate stomach upset, including nausea, vomiting, or diarrhea
Hormonal shifts, especially during menopause, and metabolic disorders such as diabetes with autonomic neuropathy can reduce salivary output, and you should include endocrine evaluation where clinical context indicates
Why the pairing is plausible The logic for combining them comes from pathway biology: tesamorelin works through the GHRH receptor, while ipamorelin works through the ghrelin/GHS-R1a receptor