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Standard practice includes baseline labs before starting, follow-up labs 4-6 weeks after initiation, and periodic kidney function and metabolic checks during ongoing use

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However, shifting your schedule too frequently can create overlapping peak levels, which might intensify side effects like appetite suppression or mild gastrointestinal changes

Therefore gut and liver function, as well as the microbiome, should be considered in cases of endometriosis

While this is not as much weight loss as seen with other agents, metformin is well tolerated and safe, and it helps treat insulin resistancean additional benefit, given that many of our patients are diabetic or prediabetic