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Mechanistically, these changes appear to coincide with elevated NAD+ and activation of metabolic gene programs consistent with increased energy expenditure

Fat storage pathways become more active

anaphylaxis to injectable thiamine, while extremely uncommon, has been reported

Quick Answer: Potentially yes they work through different pathways and may be complementary but this combination requires careful medical supervision and has not been studied in clinical trials

The STEP 5 trial showed ongoing weight loss through 104 weeks of treatment, with participants maintaining a 15.2% body weight reduction at the two-year mark

Common symptoms include persistent fatigue, pins and needles in the hands and feet, memory problems, and breathlessness