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The combination could cause: Severe hypoglycemia from excessive glucose clearance Metabolic imbalances from over-activation of energy sensing pathways Muscle catabolism from excessive AMPK signaling Fatigue and weakness from energy depletion Some protocols intentionally combine metformin and MOTS-c at reduced doses, but this requires careful monitoring and should not be attempted without medical supervision

doi: 10.1007/s40618-015-0404-6 29 HabibZAHavstadSLWellsKDivineGPladevallMWilliamsLK

In summary, while not without risks like prescription medication, clinical trial data demonstrates semaglutide to be safe and well-tolerated when carefully supervised by health experts