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Elabela/toddler is an endogenous agonist of the apelin APJ receptor in the adult cardiovascular system, and exogenous administration of the peptide compensates for the downregulation of its expression in pulmonary arterial hypertension

This is higher than the general recommendation for tirzepatide users (1.0 to 1.2 g/kg) because of the additive muscle loss risk from autoimmune disease

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