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In the second subgroup (ALC add-on vs the same background drug), Gavrilova et al 19 observed AEs in 35% with ALC add-on versus 45% with antidepressant alone, and Ramezani et al 20 reported AEs in three patients (1 in ALC + sertraline, 2 in sertraline + placebo)

Effects of glucagon-like peptide-1(7-36)amide on antro-pyloro-duodenal motility in the interdigestive state and with duodenal lipid perfusion in humans

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For participants not using a GLP1-RA at baseline or throughout the study, the HR was 0.77 (95% CI 0.67 to 0.89), and with GLP1-RA at baseline or any time throughout the study the HR was 0.82 (95% CI 0.45 to 1.48) [64]

The altered autoregulation of blood flow cannot meet the metabolic demand of tissues in ME/CFS, leading to tissue hypoxia and subsequent ischaemia/reperfusion injury with its associated symptoms and signs (29)