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Most patients need testing every 3-6 months during active treatment, with baseline testing before starting medications (American Diabetes Association 2025)

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Thus, adding an additional commercially available drug, such as B12, is insufficient to justify compounding a GLP-1 medication

Side Effects Unusual moods or behaviors, thoughts of hurting yourself, feeling depressed Rash, swollen or tender glands in the neck, armpit, or groin Blistering, peeling, red skin rash Warnings Tell your doctor if you are pregnant or breastfeeding, or if you have kidney problems (including patients receiving dialysis) or lung problems

One such adaptation she and her colleagues have been studying is an increase in the amount of the enzyme glutamine synthetase, which makes glutamine from other starting materials, namely glucose