can you take glp 1 and metformin together Use Ozempic Together? Combining Ozempic and Metformin: Can

Orforglipron (Foundayo) is a once-daily GLP-1 pill for weight loss

GLP-1 drugs could rapidly evolve beyond current use as diabetes and weight loss medications, with new research pointing to potential benefits in cancer, ageing, addiction, osteoarthritis and heart health

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Others * Long-term metformin use * Proton pump inhibitors (reduce acid absorption) Pathophysiology * Impaired DNA synthesis megaloblastic anemia * Accumulation of methylmalonic acid nerve damage Clinical features Hematological * Fatigue, pallor * Shortness of breath * Megaloblastic anemia Neurological (key distinguishing feature) * Peripheral neuropathy (tingling, numbness) * Loss of vibration and position sense * Ataxia (unsteady gait) * Cognitive changes Severe untreated cases irreversible nerve damage Others * Glossitis (smooth, beefy red tongue) * Mild jaundice Investigations * Serum vitamin B12 * CBC macrocytic anemia ( MCV) * Blood film hypersegmented neutrophils * methylmalonic acid (specific for B12 deficiency) * homocysteine Differentiate from folate deficiency * Both megaloblastic anemia * Only B12 neurological symptoms Management Replacement therapy * Hydroxocobalamin (preferred IM) * Frequent doses initially, then maintenance * Oral B12 if mild and absorption intact Important rule Never give folate alone if B12 deficiency is possible may worsen neurological damage Prevention * Adequate diet (meat, eggs, dairy) * Supplementation in vegans * Monitor high-risk patients (elderly, post-surgery)

We discuss the use of glucagon-like peptide-1 (GLP-1) analogues as monotherapy and unimolecular dual or triple agonists that exploit the GLP-1 receptor and/or the gastric inhibitory peptide (GIP) receptor and/or the glucagon receptor

Common nutritional concerns associated with GLP-1 therapy may include: Reduced appetite and inadequate nutrient intake Loss of lean muscle mass during rapid weight reduction Nausea, digestive discomfort, and poor food tolerance Fatigue and reduced energy levels Micronutrient deficiencies over long-term use Increased nutritional needs in patients with complex clinical conditions Effective GLP-1 treatment requires more than medication alone