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Taking topiramate while on a ketogenic diet can increase your risk of metabolic acidosis (a chemical imbalance where there is too much acid in the bodily fluids)

Step 3: Gather your supplies Before your first injection, you need the following items ready: Insulin syringes (1 mL/100 unit or 0.5 mL/50 unit, with 29-31 gauge needles) Alcohol swabs (for cleaning vial top and injection site) Sharps container (for safe needle disposal) Your compounded tirzepatide vial Bacteriostatic water (only if your vial requires reconstitution ) A tracking journal or app (for logging doses, side effects, weight, and measurements) For microdosing specifically, 0.5 mL (50 unit) syringes offer better precision than 1 mL syringes because each unit marking represents a smaller volume

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This is where oxidative stress can occur if the body isn't equipped to move to the next step quickly