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Muscle quality, insulin sensitivity, mitochondrial efficiency, intramuscular fat , may actually improve on GLP-1 therapy
In any case, the article in question was a review paper by Iranian scientists of all the publications they could find in the scientific literature that had in any way related the use of berberine to weight control

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Thyroid disease doesn't automatically disqualify you from GLP-1 weight loss therapy, but careful medical oversight is essential

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Some of the largest organizations in the US spend upwards of $16,000 per person per year on costs associated with GLP-1s