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The preclinical evidence is robust, consistent, and mechanistically plausible, but the gap between rat sciatic nerve transection models and human diabetic neuropathy is significant

Instead of asking 'why not stack them,' the question becomes 'what specific outcome justifies adding a second compound with incomplete human safety data?' For research exploring maximal metabolic intervention where single-agent tirzepatide has plateaued, the stack may be defensible

However, the level of creatine synthesis in the embryonic nervous system is not sufficient for needs and so the developing brain requires maternally and peripherally synthesized creatine