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Unreconstituted lyophilized tirzepatide has a dramatically longer shelf life (up to 24 months) compared to reconstituted liquid (28 to 30 days)

Biochim Biophys Acta 1830(5):31433153

Expect a small additive effect over time

Lu J, Zhao Y, Liu M, Lu J, Guan S

The expansion of Enterococcaceae may partly reflect radiation-associated intestinal dysbiosis, and its detection during radiotherapy could help capture clinically relevant fluctuations in microbial burden and community structures 71,134