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Whilst both are marketed for metabolic support and weight management, their combined use lacks robust clinical evidence

doi: 10.3899/jrheum.160522 5 RaduAFBungauSG

Long-term safety, interaction, endocrine, metabolic, and population-specific data remain incomplete

Altered gene expression of the astrocytic lactate efflux transporter (monocarboxylate transporter 4, SLC16A4) together with reduced lactate levels found in the spinal cord of hSOD1 G93A mice further suggest that metabolic interaction between neurons and astrocytes may be disrupted in ALS (Ferraiuolo et al., 2011)

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