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This is where L-Carnitine steps in

Everything needs to be in balance.[ref][ref] Prostate cancer risk is increased with 4-HOE1(E2) metabolites also.[ref] In general, the estrogen metabolites that start with 2 are good, and the ones that start with 4 or 16 need to be limited or at least eliminated quickly from the body.[ref] Here is a diagram of how these metabolites go together: As you can see, upregulating the CYP1A1 enzyme is going to increase the 2-OHE1 path

This inhibition causes AICAR to accumulate intracellularly

Like orforglipron, these occur most frequently during dose titration and tend to improve over time