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The GCGR arm adds hepatic thermogenesis and lipolysis that tirzepatide does not generate
Summary: Berberine may interact with numerous prescription medications by inhibiting liver enzymes (particularly CYP3A4, CYP2D6, CYP2C9) and P-glycoprotein, potentially altering drug levels and increasing risks of adverse effects or treatment failure
doi: 10.1097/00000658-199010000-00005
The liver stores are a bit irrelevant to someone who has PA or a B12 absorption problem though because the mechanism that is used to release them relies on the same mechanism that is used to absorb most dietary B12 so accessing any stores is at best very inefficient
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