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GLP-1 receptor agonists exert their therapeutic effects through several mechanisms : they stimulate insulin secretion from pancreatic beta cells in a glucose-dependent manner, suppress glucagon release (which reduces hepatic glucose production), slow gastric emptying, and act on appetite centres in the hypothalamus to promote satiety and reduce food intake

It has been suggested that these drugs could act through the non-classic RAAS pathways in the context of simultaneous RAAS blockade

If testosterone deficiency is suspected, total testosterone should be measured in a morning sample (typically between 9 and 11 am) and repeated if low, with consideration of luteinising hormone (LH), follicle-stimulating hormone (FSH), and prolactin when indicated Blood pressure monitoring to confirm adequate control before considering medication changes Several management options may be considered depending on your individual circumstances

It is the difference between a successful protocol and an expensive experiment in frustration