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repletion reverses hematologic symptoms within days and neurologic sequelae over weeks, reflecting differential tissue turnover
Moreover, skatole, a tryptophan-derived metabolite typically low in healthy individuals, was also elevated, suggesting disruption of gut homeostasis (Fournier et al., 2023)
When intracellular glutathione levels are sufficient, this feedback mechanism suppresses further synthesis, preventing excessive accumulation of pathway intermediates
Evidence from clinical trials shows that serious reactions to GLP-1 RAs are rare