Congrats jason_sac26!! You should be so proud of yourself. 🎉

Slightly tangential to International vendor but Admin reminded me — does anyone have experience combining this with metformin?

I know it is not exactly on-topic but it seems related enough to ask here rather than starting a new thread. Apologies if this has been covered — I did search first.

Yep. My endo said the same thing about International vendor.

Reading this thread on International vendor hits close to home. Night shift nurse — I started at 295 lbs and felt like I would tried everything.

11 months on tirz and I am a different person. Not just the 70 lbs lost — my energy, my mood, my relationship with food. All transformed.

If you are on the fence about International vendor — take the leap. It was the best health decision I have ever made. ❤️

As a pharmacist, I want to add some clinical context to this discussion on International vendor directory need.

Building on what Dr.LipidDallas said — the evidence base here is robust. The key publications to reference are from the SURMOUNT program[1].

Key clinical points:

1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
2. Side effect profile is predictable and usually manageable with standard protocols
3. Monitoring should include baseline labs and follow-up at 3-month intervals
4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.