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First, define "not working" Give tirzepatide a fair trial

Yes, stress can indirectly increase melanin production by triggering inflammation and hormonal changes

After a 2 week screening period all eligible participants were randomly assigned to treatment groups receiving either a subcutaneous injection of 2.4 mg of semaglutide, 2.4 mg of cagrilintide, a combination of cagrilintide and semaglutide, a semaglutide placebo, or a cagrilintide placebo [2]

While standard B12 injections exist on their own, lipotropic B12 injections introduce B12 alongside methionine, inositol, and choline

As a result of that, initial recommendations focus on the use of metformin or a thiazolidinedione if metformin is contraindicated, followed by a GLP-1 agonist or a DPP-4 inhibitor