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E., Schweizer, A., Couturier, A

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In the STEP clinical trials, semaglutide 2.4 mg (Wegovy) demonstrated average weight loss of approximately 15% of initial body weight over 68 weeks when combined with lifestyle interventions

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Throughout an average day, our cells get exposed to toxins and waste through the foods we eat, our environment, and even basic cellular processes

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Request the following labs before starting and then at 3 and 6 months: Total testosterone (optimal: 500 to 900 ng/dL for most men) Free testosterone (optimal: 15 to 25 pg/mL) Estradiol (optimal: 20 to 40 pg/mL) SHBG (reference: 10 to 57 nmol/L) LH and FSH (reference: LH 1.8 to 8.6 mIU/mL, FSH 1.5 to 12.4 mIU/mL) If testosterone is rising and estradiol is falling over time, the trajectory is positive regardless of how you feel in the short term

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However, up to 40% of patients do not achieve satisfactory relief, prompting investigation of combination therapy, most commonly adding a second agent (e.g., duloxetine plus pregabalin), which can yield incremental pain reduction of 1020% but with increased risk of sedation, dizziness and drug interactions [64]

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