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Yang D, Xie J, Liang XC, Cui YZ, Wu QL

No published trials directly compare berberine alone to semaglutide or tirzepatide, and no large studies have tested the combination in humans, leaving the synergy question open

And metabolic impact analysis indicated that treatment with L-carnitine combined with trimetazidine can perturb the metabolism of amino acids, branched-chain amino acids, carbohydrates, and TCA intermediates (Figure 7B)

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Abrupt discontinuation can cause rebound appetite and metabolic changes

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