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Information about environmental lighting conditions reaches the pineal gland via a complex neuronal pathway starting in the retina of the eye: retina retinohypothalamic tract SCN paraventricular nucleus medial forebrain bundle midbrain tectum intermediolateral nucleus of the spinal cord superior cervical ganglion postganglionic sympathetic fibers pinealocytes of the pineal gland MELATONIN METABOLISM Circulating melatonin in the blood undergoes rapid metabolic transformations in the liver, primarily hydroxylation at position 6, followed by conjugation of 6-hydroxymelatonin with sulfuric or glucuronic acid

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In a combination protocol, the same titration applies, but the timing of when you introduce cagrilintide relative to your retatrutide titration becomes the critical variable