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This intricate nexus, predominantly involving peripherally activated immune cells, notably circulating monocytes, and microglia, along with its repercussions on signaling pathways like serotonin, dopamine, and corticotropin-releasing hormone, with the latters implications on the hypothalamus-pituitaryadrenal axis, initiates sickness behaviors, including fatigue (4, 8)

A scoping review published in 2025 in the journal Cureus noted an increasing number of reports of people losing hair while being treated with tirzepatide, dulaglutide and semaglutide

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