If your needs evolve or your goals shift, your treatment plan evolves with you
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doi: 10.3389/FPHAR.2023.1147414 263 Amir AslaniBGhobadiS
Examples Metformin Dosage Immediate release Initial: 500 mg once or twice daily OR 850 mg once daily Maximum: 2,550 mg daily (dosages above 2,000 mg daily are typically administered in three divided doses) Extended release Initial: 5001,000 mg once daily Maximum: 2,000 mg daily Possible side effects include: Gastrointestinal: diarrhea, nausea, and/or abdominal discomfort Vitamin B12 deficiency (and elevated homocysteine) Testosterone reduction (blood tests can measure this and natural testosterone prescription creams may be considered) Oral glucagon-like peptide-1 (GLP-1) receptor agonist Primary mechanism(s) of action Enhance incretin signaling to increase glucose-dependent insulin secretion, reduce post-prandial glucagon, and delay gastric emptying (resulting in reduced after-meal glucose levels and increased satiety) Examples Semaglutide (Rybelsus) is the only approved medication in this class as of early 2022
Although oral therapy with the least toxic of these compounds, glutathione monoethyl ester, did raise erythrocyte and white blood cell glutathione levels in a few affected patients (W Rhead, unpublished results), it also provoked moderate gastrointestinal irritation resulting in vomiting and diarrhea, largely precluding oral therapy with this compound or other related molecules containing free sulfhydryls
