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In this scenario, choosing a compounded version with b12 added costs only slightly more than compounded semaglutide alone, making the combination potentially worthwhile even without clear medical necessity

an impure compound means you're not administering the intended amount of active substance

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10.1016/j.biopsych.2016.08.035 Biol

This is as high as the approved dosing schedule goes, typically reached only after twenty or more weeks of gradual escalation