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A critical contributor is reduced activity of the sarcoplasmic reticulum Ca 2+ -ATPase (SERCA2a), accompanied by a relative increase of unphosphorylated phospholamban (PLN), a SERCA2a inhibitor 8,9,10

doi:10.5664/jcsm.7638 Batool-Anwar S, Goodwin JL, Kushida CA, et al

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Furthermore, MP-treated oocytes showed higher cytoplasmic abnormalities and depleted glutathione levels (Nair et al., 2014
Adding an oral dose with unpredictable absorption on top of residual injectable tirzepatide creates uncontrollable blood levels
