I've used up ampoules that are long out of date and have been subjected to fluctuating heat (terrible for wine!) due to being in my car, etc, and haven't noticed any difference
Its job is to help regulate blood sugar and control the livers glucose production
A more evidence-based way to evaluate whether something is helping is to track measurable outcomes with your clinician (for example, symptoms tied to confirmed deficiency, or objective metrics like body weight, waist measurements, and lab work when appropriate)
Approximately four weeks at 2 to 8 degrees Celsius, upright, protected from light
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Most researchers notice appetite reduction from tirzepatide within the first week