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However, in OA, M2 numbers are limited and may shift toward an M1-like phenotype under sustained inflammatory stimuli, reducing their capacity to maintain iron homeostasis (109, 110).Together, these insights support the hypothesis that iron metabolism in M1 macrophages not only contributes to ferroptosis susceptibility in OA, but also represents a potential immunometabolic checkpoint for therapeutic intervention

This dual-mechanism approach addresses both fat liberation and cellular energy productiontwo processes that single-agent therapies rarely optimise simultaneously

4 Adverse physiological effects of metformin Metformin is associated with a range of adverse physiological effects, involving the gastrointestinal and nervous systems, reproductive function, body weight regulation, tumor biology, and acid-base homeostasis

Together, Ginkgo biloba, NAD, and MNM support brain health, boost memory, and promote an energetic, youthful body by improving blood circulation, repairing cells, and reducing oxidative stress