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We herein report the case of a 15-year-old patient with MTHFR deficiency presenting with a slowly progressive mental decline and spastic paraplegia, followed by rapidly progressive psychosis and repetitive seizures triggered by infection that successfully responded to betaine treatment

What payers require for Zepbound prior authorization Zepbound PA requirements are typically more stringent: Documented BMI of 30 or greater, or 27 or greater with at least one weight-related comorbidity Evidence of lifestyle intervention including documented participation in diet, exercise, and behavioral modification programs (usually for at least 3 to 6 months) Prior medication trials (some plans require documented failure of other weight management medications before approving tirzepatide) Specialist involvement (some plans require referral to or management by a bariatric medicine specialist, endocrinologist, or obesity medicine physician) Ongoing weight monitoring documentation with specific weight loss targets (typically 5% of baseline weight within 3 to 6 months of starting therapy) Patients researching BMI requirements for GLP-1 medications should understand that these thresholds directly correspond to the prior authorization criteria their provider must document

Tip: Rotate injection sites each time to prevent soreness or tissue damage

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