In an uncontrolled trial in 100 men with infertility, a combination supplement containing 800 mg alpha-lipoic acid, 100 mg betaine, 400 mcg folic acid, 1,000 mg myo-inositol, 2.6 mg B12, 1.7 mg riboflavin, and 1.9 mg B6 was tested and reported to improve sperm concentration, motility, and morphology
An intranasal spray solution of B12, also called Nascobal, with the same indications, was FDA approved in January 2005
For patients who tolerate well and want to push results, we sometimes increase Retatrutide to 8mg weekly between weeks 9 and 12, and bump MOTS-C to three times per week
Glucagon receptor agonism increases energy expenditure and promotes hepatic fatty acid oxidation, which may contribute to reductions in liver fat content
At this concentration, a 4mg dose requires a full 2mL injection, which is uncomfortably large and will likely hurt at the injection site