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The risk is considered so low that routine thyroid ultrasound screening is not recommended for most patients starting these drugs

2022 Jul 20;13(7):630.

Qsymia combines two older medications, phentermine and topiramate, into a single oral capsule

That's not a reason to dismiss the product - smaller doses still feed gut bacteria - but it is a reason to calibrate your expectations honestly and not assume the supplement will produce the same results as those reported in gram-level clinical trials

One rat study found that when DSIP activity was blocked, the post-sleep-deprivation spike in GH and slow-wave sleep was also blocked

Growth hormone secretagogues in hypogonadal males