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It has also been shown that pollutants affect the metabolism of isolated human cells which in turn resulted in highly increased oxidative stress levels and consequently cell damage and reduced cell activity leading to cell death

doi: 10.1210/jc.2008-2760 225 SiemensmaEPCde Lind van WijngaardenRFAOttenBJde JongFHHokken-KoelegaACS

"The open question is real-world performance

Combining both agents could theoretically amplify appetite suppression and gastrointestinal effects, though long-term safety data on this specific combination is lacking

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