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Options include: Other GLP-1 receptor agonists (such as semaglutide or dulaglutide), though these share similar mechanisms and side effect profiles SGLT2 inhibitors (such as dapagliflozin or empagliflozin), which work through different mechanisms and have cardiovascular and renal benefits DPP-4 inhibitors (such as sitagliptin), which have a more modest effect on glycaemic control and weight Metformin (if not already prescribed), which remains the first-line treatment for type 2 diabetes according to NICE guidelines Insulin therapy (for patients requiring more intensive glycaemic control) For weight management specifically , alternatives to tirzepatide (Zepbound) include semaglutide 2.4 mg (Wegovy), which is approved by NICE for managing overweight and obesity, orlistat, or comprehensive lifestyle intervention programmes

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lactis daily for 30 days was also found to reduce constipation symptoms in a small controlled trial with 30 female participants (Favretto 2013)

Physical Activity: While exercise is healthy, intense physical training increases oxidative stress, which may temporarily deplete glutathione levels