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Several important factors warrant consideration: Concurrent medications and supplements frequently contribute to gastrointestinal symptoms

This, in turn, boosts metabolic rate and activates a gene known as sirtuin-1 (SIRT1), also referred to as the "longevity gene." SIRT1 is involved in reducing the risk of various conditions such as diabetes, obesity, metabolic syndrome, atherosclerosis, cardiovascular disease, kidney disease, liver disease, neurodegeneration, and cancer.

This is not the same as saying the combination is safe at all doses for all patients

Additionally, phentermine can provide extra appetite control and increase activity levels, complementing GLP 1 & GIP therapys effects

But metformin can also affect vitamin B12 absorption, she says