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The appetite-suppressive effects create a secondary concern: patients taking both drugs may inadvertently restrict calories to unsafe levels, leading to nutrient deficiencies, muscle loss, or metabolic adaptation that undermines long-term weight loss

Reverse transcription from RNA to cDNA was performed using the SuperScript IV First-Strand Synthesis System (Invitrogen)

Retatrutide adds a third pillar by targeting the glucagon receptor, which is designed to increase the basal metabolic rate and fat oxidation

Our results revealed that betaine and DMG levels, as well as the betaine: choline ratio, were reduced in COC users, whereas choline, serine, and the DMG: betaine ratio were significantly increased in COC users compared with controls (Table 4)