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They're the long-established standard of care, both FDA-approved, both backed by decades of clinical data

Inhibition of -KG-dependent histone and DNA demethylases by fumarate and succinate that are accumulated in mutations of FH and SDH tumor suppressors

Conservative starting doses would be essential: Initial phase : Cagrilintide 0.3 mg + Tirzepatide 2.5 mg weekly Escalation : Increase cagrilintide by 0.3-0.6 mg every 4 weeks Tirzepatide adjustment : Maintain or modestly increase based on tolerance Monitoring : Close observation for cumulative GI effects This remains speculative, as no published trials have examined this specific combination

it is almost sodium free"