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Provider-prescribed treatments. Subject to medical evaluation. Medications are dispensed by licensed U.S. pharmacies.

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Combination Guide

What Works Together — And What to Avoid

Understanding which therapies complement each other — and which combinations require caution or must be avoided — helps you have more informed conversations with your provider.

Important: This guide is educational only. All treatment combinations are determined by your licensed provider after reviewing your individual health history. Never start or stop therapies without provider guidance.

Synergistic Combinations

These pairings are commonly used together because their mechanisms complement each other.

GLP-1 + MICC Injection

Weight LossMetabolism

MICC (Methionine, Inositol, Choline, B12) supports liver fat metabolism and provides an energy boost — complementing the appetite reduction of GLP-1 therapy. Frequently prescribed together.

Very commonly combined by providers. Safe and synergistic.

GLP-1 + L-Carnitine Injection

Weight LossFat Metabolism

L-Carnitine shuttles fatty acids into the mitochondria for energy. When the body is actively burning fat on a GLP-1 program, L-Carnitine may support that metabolic process.

Frequently included in weight management protocols alongside GLP-1 therapy.

GLP-1 + B12 (Methylcobalamin)

Weight LossEnergy

Patients on GLP-1 programs often reduce caloric intake significantly. B12 supplementation helps maintain energy levels and supports neurological health during this process.

Safe and supportive — often included in comprehensive weight management programs.

BPC-157 + TB-500

RecoveryHealing

BPC-157 promotes tissue healing via growth factor and angiogenesis pathways. TB-500 (Thymosin Beta-4) supports cellular repair through actin regulation. Together, they address healing from complementary angles.

A widely used recovery stack. Protocols determined by your provider.

CJC-1295 + Ipamorelin

LongevityGH Support

CJC-1295 extends the GHRH signal, while Ipamorelin provides a complementary GHRP signal. Together they create a more sustained, physiological GH pulse than either alone. Designed to be used as a stack.

The combination is the standard approach — these are typically prescribed together.

NAD+ + Glutathione

LongevityAntioxidant

NAD+ supports cellular energy and DNA repair. Glutathione is the body's primary antioxidant. Together they support cellular health from both energy-production and oxidative-stress angles.

Popular longevity pairing. Provider determines administration method and timing.

GLP-1 + NAD+

Weight LossLongevity

NAD+ supports the metabolic and mitochondrial function that underpins energy balance. Some patients on GLP-1 programs find NAD+ helps maintain energy during dose escalation.

No known interactions. Discuss with your provider to ensure appropriateness for your situation.

Combinations Requiring Caution

These combinations aren't necessarily off-limits — but they require extra provider coordination and disclosure.

Two GLP-1 Medications Simultaneously

Do not combine semaglutide and tirzepatide — they act on overlapping pathways and combining them does not improve outcomes but increases side effect risk. Your provider will choose one.

Avoid without explicit provider direction

GLP-1 + Other Diabetes Medications (without supervision)

If you take insulin or other blood sugar medications, adding a GLP-1 agonist requires careful provider oversight to prevent hypoglycemia (dangerously low blood sugar). Always disclose all medications.

Requires provider coordination

Sermorelin + Active Cancer History

Growth hormone-related peptides like Sermorelin and CJC-1295/Ipamorelin may stimulate cell growth pathways. Patients with a history of hormone-sensitive cancers (e.g., prostate, breast) require extra screening.

Provider must review cancer history first

Multiple Growth Hormone Peptides (Sermorelin + CJC-1295 + Ipamorelin)

Stacking multiple GH-supporting peptides without provider guidance can oversaturate growth hormone pathways. Your provider determines the appropriate protocol.

Provider protocol required

NAD+ + Active Cancer Treatment

While NAD+ has many health benefits, its cell-energizing properties require provider clearance in patients undergoing active cancer treatment.

Requires oncologist clearance

Absolute Contraindications

These are firm exclusions — not gray areas. If any of these apply to you, be sure to disclose them during your medical intake.

Pregnant or breastfeeding patients

All GLP-1 medications, all peptide therapies (BPC-157, TB-500, Sermorelin, CJC-1295), and most injectable vitamins are contraindicated. Always inform your provider of pregnancy status.

Patients with personal or family history of MTC or MEN 2

GLP-1 receptor agonists (semaglutide, tirzepatide) are absolutely contraindicated. This is a firm exclusion — not a gray area.

Patients with active, untreated cancer

Growth hormone peptides (Sermorelin, CJC-1295, Ipamorelin) and immune-modulating compounds should not be started without oncologist clearance.

Patients with severe gastroparesis

GLP-1 medications significantly slow gastric emptying — combining them with severe gastroparesis can worsen symptoms. Disclose GI conditions during intake.

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