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JAMA (2018)

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For instance, patients using both medications had significantly lower blood sugar levels and greater weight loss compared to those on metformin alone

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Factors Indicating Need for Dose Escalation Increase doses when minimal subjective improvements after 3-4 weeks at current dose, IGF-1 levels show minimal or no meaningful increase from baseline after an adequate trial period (e.g., 812 weeks), good tolerance without significant side effects suggesting room for higher dosing, and treatment goals require more aggressive approach than current dose provides

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Timothy Garvey, M.D., professor in the UAB School of Health Professions

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Hormonal hunger signals override willpower

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