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Other serious but rare side effects include pancreatitis (severe stomach pain, fever, nausea, vomiting), gallbladder problems (yellowing of skin or eyes, upper stomach pain), kidney injury (decreased urination, swelling), diabetic retinopathy (vision changes), severe allergic reactions (rash, swelling of face/throat, difficulty breathing), increased heart rate, and new or worsening depression or suicidal thoughts

the most common side effects are gastrointestinal, including nausea, vomiting, and diarrhoea, consistent with the GLP-1 receptor agonist class

We offer encouragement to healthy supplement choices, lifestyle measures, and behavioral plans that get maximum focus on energy in a natural way

The necropsy was performed afterward using the previously reported method with minor adaptation 19

We thank Ms Colleen Pisaneschi for editing the manuscript and Sigma-Tau (Pomezia, Italy) for the gift of acetyl-L-carnitine

Lyle GW