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In response, cervical stretching stimulates additional oxytocin to be synthesized by the hypothalamus and released from the pituitary

The complex pathophysiology and the metabolic risk factors shared between type 2 diabetes, obesity, CKD and cardiovascular disease have led to the concept of a cardiovascularkidneymetabolic (CKM) syndrome

Some patients notice initial improvements within one week, with optimal results developing around three months as collagen production increases

Published trials are sparse, but a 2023 observational study reported modest additional weight loss (35 lbs over 12 weeks) with combination therapy versus single-agent, though nausea and dizziness occurred in 34% of patients