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usually most pronounced during dose escalation Diarrhea : Affects 12-17% of patients, typically mild to moderate in severity Vomiting : Reported in 6-10% of patients, more common at higher doses Constipation : Occurs in 6-11% of patients Abdominal pain and dyspepsia : Generally transient Decreased appetite : An expected pharmacological effect contributing to weight loss Other documented adverse effects include injection site reactions, hypoglycemia (when used with insulin or sulfonylureas), and less commonly, fatigue

The combination has been associated with elevated sirtuin activity, altered adipocyte differentiation markers, and changes in muscle stem cell quiescence and proliferation in the cited preclinical literature

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Beyond supporting red blood cells, vitamin B12 is also crucial for healthy nerve and brain function and is involved in the metabolism of every cell in the body
