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Gallbladder and biliary disease Several meta-analyses have found that GLP-1 agonists carry a modest increase in the risk of gallbladder or biliary disease (such as gallstones and cholecystitis), especially at higher doses, over longer durations, and when used mainly for weight loss [3]

The combination protocol preserves insulin sensitivity and allows natural GH troughs that promote fat oxidation, while MK-677's sustained elevation antagonizes insulin signaling and reduces fasting lipid oxidation rates