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Liraglutide consistently promoted the growth of Akkermansia muciniphila, a microbe known to support gut barrier integrity and metabolic health
Adding the metabolic demands of ketosis on top of this can increase fatigue, reduce energy for exercise and make it harder to hit adequate protein targets
A 2014 trial tested 4 grams per day of IV L-carnitine for 12 weeks in patients with metabolic syndrome and found improvements in body weight, cholesterol levels, insulin sensitivity, and inflammation markers
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Many also rely on partners, friends or family for reminders (41%) - despite clinical guidance recommending medication is usually taken at the same time each week
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