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Vitamin B12 deficiency is one of the most documented concerns with GLP-1 therapy, and adequate B12 is essential for energy production, neurological function, and red blood cell formation

Growth hormone overexpression in the central nervous system results in hyperphagia-induced obesity associated with insulin resistance and dyslipidemia

The downstream effects show up across the body: Fatigue that doesn't improve with sleep, because nutrient absorption is compromised Iron deficiency or B12 deficiency anemia, even with adequate dietary intake Skin issues like rosacea, eczema, or acne that flare with certain foods Brain fog, difficulty concentrating, poor short-term memory Joint pain or body aches driven by systemic inflammation Unintentional weight changes, either gain or loss depending on the type of SIBO Mood changes, anxiety, or depression linked to disrupted gut-brain signaling Patients who've been dealing with these symptoms for years often don't connect them to their gut

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However, any combination therapy should be supervised by a qualified physician who can monitor your lab values and adjust protocols accordingly