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At clinical doses under supervision, the most common side effects are mild nausea in the first week (typically resolves by day 7 to 10), injection site reactions (redness, minor swelling, localized soreness lasting 24 hours), and occasional transient fatigue or mild headache in the first few days

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Seiwerth et al., 2018), and regardless given highly sophisticated evidence (Tarnawski and Ahluwalia, 2012

And some people may have low levels despite having no symptoms

Plain sparkling water contains no calories, sugar, or active ingredients that would affect blood glucose control or interact with tirzepatide's mechanism of action