- clinically significant hepatic, renal, or cardiac impairment (as determined by previous clinical judgement) - hypoglycemia - currently on drugs for covid-19 - hospitalization for covid-19 - (suspected) pregnancy or breastfeeding - active cancer - uncontrolled mental health issues - on any medication with major interactions with metformin or ldn - taking opioid analgesics, or being treated for opioid addiction/recovery - opioid dependence or withdrawal syndrome - known sensitivity to metformin or naltrexone - current users of metformin or naltrexone

- clinically significant hepatic, renal, or cardiac impairment (as determined by previous clinical judgement) - hypoglycemia - currently on drugs for covid-19 - hospitalization for covid-19 - (suspected) pregnancy or breastfeeding - active cancer - uncontrolled mental health issues - on any medication with major interactions with metformin or ldn - taking opioid analgesics, or being treated for opioid addiction/recovery - opioid dependence or withdrawal syndrome - known sensitivity to metformin or naltrexone - current users of metformin or naltrexone