Yes, combining metformin with GLP-1 agonists is safe and clinically recommended for many patients
Diagnosis can be made with a combination of studies (send out labs for most folks): plasma free & total carnitine, plasma amino acids, urine orotic acid, plasma acylcarnitines, urine organic acids, comprehensive metabolic panel, creatinine kinase, and a lactate level
Anyone weighing CJC-1295, Ipamorelin, or any other option discussed here should consult a licensed medical provider before pursuing any peptide protocol
however, being aware of possible issues allows for prompt recognition and an appropriate response
Switching up where you inject helps avoid soreness and ensures the shot works well