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If you are on multiple medications, particularly insulin, sulfonylureas, or other glucose-lowering drugs, the interaction management requires more oversight than a text consultation typically provides

However, patients tend to see the best results after having been on the medication for more than six months

chronic conditions that have been present for months may need the full 8-week protocol

Why it matters: Insurance decisions are documentation-driven, not based on personal preference

This energy dysfunction is thought to be due to a compromised tricarboxylic acid cycle enzyme, -ketoglutarate dehydrogenase activity, limited anaplerotic flux and capacity of astrocytes to detoxify ammonium by glutamine synthesis, increased lactate synthesis as well as mitochondrial permeability transition induced by oxidative/nitrosative stress [34, 35]