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Combining these therapies that target mesolimbic hedonic hunger and hypothalamic appetite regulation may synergistically affect weight loss

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When cognitive symptoms occur in patients taking metformin, clinicians should investigate alternative explanations, including metabolic disturbances that may be indirectly related to the medication, rather than assuming the drug directly causes neurological impairment

[15] [16] Tests may include full blood count, serum B12 levels, anti-intrinsic factor antibodies (to diagnose pernicious anaemia), and sometimes methylmalonic acid or homocysteine levels when the diagnosis is uncertain

Regular blood tests may also be required to ensure that semaglutide is not causing any unwanted effects and to monitor the overall health of the patient