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Normally microglia are neuroprotective, cleaning out debris that may contribute to neurodegenerative diseases or damage from ischemic stroke, but in the case of TBI they can become overactivated and exacerbate neuroinflammation (with upregulated TNFa, IL-6, C3, NK-kB, CD68, etc), and vascular changes can result in headaches, neurovascular flow changes, impaired lymphatic flow, blood-brain barrier disruption, activation of pro-inflammatory pathways, neuronal death, hyperexcitability, and disrupted synaptic connections

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Patients typically begin with 0.25 mg of Ozempic after waiting one week from their last Mounjaro dose

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