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Although the role of L-lactate in exercise, hypoxia, and metabolic diseases has been extensively studied, the physiological and pathophysiological roles of D-lactate remain poorly understood

doi: 10.1186/s12885-017-3055-5 150 VelmuruganBBhuvaneswariVNaginiS

In practice, that same additive quality is also the main risk: two strong satiety agents together can suppress appetite and slow the gut more than intended, which is why tolerability not maximum weight effect tends to be the limiting factor in any amylin-plus-incretin discussion

In addition, rather than leading to an increase in rT3 levels directly caused by an imbalance in DIO3, the available data imply that Se deficit may indirectly cause these levels to rise via reduced clearance of DIO1 and changes in peripheral thyroid hormone metabolism [33]