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Its a subtle but significant difference
Reduced appetite suppression, diminished weight loss results, or an unusually high number of injection site reactions after previously successful doses may signal that older vials have degraded
doi: 10.1016/j.peptides.2006.05.011 Summary Keywords tirzepatide, suicide, obesity, psychiatry, diabets mellitus Citation Yu W-S, Huang J-Y, Lo S-C, Huang C-N, Yang Y-S and Kornelius E (2025) Association of tirzepatide and the risk of suicide in a real-world cohort
So does a paper notebook
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