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First, the quality of the PCOS GLP-1 evidence is generally moderate to low: trials are small, short, heterogeneous in design and comparator, and often use surrogate rather than hard reproductive endpoints, so even the class with actual PCOS data is not on firm regulatory footing for this use

10.1093/gerona/glu098 47 GormanG

The article says these distinct mechanisms may theoretically complement each other, while also stacking cardiovascular and neurological effects

Supplement with methylcobalamin, B2, B6 and methyl folate

The most common side effects are nausea, vomiting, constipation, and abdominal discomfort, typically mild and temporary