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Transdermal delivery systems may additionally cause local skin reactions , including redness, itching, or irritation at the application site

And it goes back to something I do want to really clarify for listeners

The activation of G s protein will then have a double effect: (1) It induces the release of GH stored in secretory granules by allowing the entry of Ca ++ into the cell, and (2) the s subunit activates the adenylyl cyclase (AC), which leads to increased cellular levels of cAMP [26, 30, 31]

Messer is a huge proponent of coupling the treatments (she favors low doses of tirzepatide, which often has fewer side effects than semaglutide)