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The synthesis: For most patients, "tirzepatide now, consider retatrutide later" is the right framing

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9 , 11 , 12 Musculoskeletal and neuropathic pain, accompanied by central sensitisation, are key features of hEDS, although the exact cause of pain remains unclear.13, 14, 15 Small fiber neuropathy (SFN) could be a peripheral substrate of neuropathic pain, while central sensitization could be a central component of pain.16, 17, 18 Orthostatic intolerance is frequent, affects most hEDS patients, and is associated with impaired quality of life