Depletion of the GM leads to the loss of its mediated negative feedback control on BAs synthesis, reduced signaling to the FXR, elevated hepatic BAs concentrations, impaired biliary barrier function, and ultimately exacerbation of CLI [74]
Side effects often relate to dose increases , eating patterns, hydration, and how quickly treatment is stepped up
One particularly instructive case involved a post-thyroidectomy patient who had been stable on levothyroxine replacement for years
Because of this gap, clinical advice often leans on what we know about how these medications behave in the body and whats considered possible in theory, rather than large studies in breastfeeding families
Cell Metab 26:278
More importantly, addiction is a form of brain learning, and glutamate is the key to both learning and un-learning addiction