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To keep these risks low and ensure the medication does its job, its crucial to follow the prescribed schedule exactly

In vitro and animal studies show that berberine can increase the systemic exposure and half-life of metformin, potentially increasing metformin's effects and side effects

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There are documented case reports of extreme appetite suppression and psychiatric complications requiring GLP-1 discontinuation in people with restrictive eating patterns ( Leziak et al., J Psychiatric Research, 2026 )

Clinicians call this pattern TOFI : thin on the outside, fat on the inside