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You should seek medical advice if: Sleep disturbances persist for more than two to three weeks despite implementing sleep hygiene measures Insomnia is severe enough to significantly impair daytime functioning, concentration, or quality of life You experience symptoms suggestive of sleep apnoea, such as loud snoring, witnessed breathing pauses, or excessive daytime sleepiness (particularly relevant as weight changes can affect sleep apnoea) Sleep problems are accompanied by signs of depression, anxiety, or other mental health concerns You suspect nocturnal hypoglycaemia (night sweats, vivid nightmares, morning headaches, or unexpectedly low morning glucose readings) Gastrointestinal symptoms are severe, persistent, or worsening, particularly if accompanied by dehydration, inability to tolerate oral intake, or severe abdominal pain Seek urgent medical attention if you experience: Sudden severe, persistent abdominal pain (with or without vomiting), especially if radiating to the back, as this could indicate acute pancreatitis Severe abdominal pain with nausea, vomiting, or fever, which might suggest gallbladder disease Your healthcare provider will conduct a thorough assessment to determine whether sleep disturbances are related to tirzepatide, underlying medical conditions, or other factors

PubMed: 10469299 TB-4 / TB-500 product mislabeling documented bidirectional mislabeling between full-length TB-4 (43 amino acids) and the TB-500 fragment (1723, 7 amino acids) in marketed peptide products: Esposito M et al
The addition of B vitamins does not directly address the gastric emptying delay, but may support overall digestive function through different pathways
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