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Future studies should investigate liver enzymes and metabolites in NASH patients treated with L-carnitine, which could help elucidate the mechanism through which L-carnitine can prove beneficial toliver function and provide insights into novel therapeutics.

In addition, clinical trials of GLP-1RAs assessed CV safety as secondary endpoints, including, blood pressure (BP), heart rate (HR), and CV events (arrhythmia, heart failure, myocardial infarction) [98]

This provides a path forward for those who cannot access or afford branded options but still require medical support

If combining berberine and Wegovy: Start with lower doses of berberine if possible, and introduce it gradually to assess tolerability

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A key hypothesis suggests this system reduces cravings by modulating dopamine-mediated reward processing