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Key risks of combining berberine and semaglutide include: Low blood sugar (hypoglycemia), particularly if you also use insulin or sulfonylureas Worsening GI symptoms such as nausea, cramping, bloating, diarrhea, or constipation Drug interactions from berberines effects on liver enzymes, which can change levels of other prescriptions These risks are the reason a clinician should review your full situation before you start the combo
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