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If three or more cortisol indicators persist (wired at night and tired in the morning, 2 to 3 pm crash, evening cravings without hunger, disrupted sleep, stalled loss despite adherence), consider diurnal salivary cortisol testing (section 9)

GLP-1 receptor agonists are contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2

Impressively, both of these approaches have achieved greater weight loss than targeting each receptor alone, 40 -42 though there is ambiguity in understanding how this works and any direct effects on the kidney likely rely on GLP-1 signaling

Learn more about the PlexusDx Semaglutide protocol or the oral semaglutide protocol inside the Weight Management Protocols collection