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If muscle symptoms are severe or persistent despite these interventions, clinicians should consider laboratory evaluation including creatine kinase, comprehensive metabolic panel with separate magnesium and calcium testing, thyroid function tests, vitamin D levels, and vitamin B12 levels to exclude alternative diagnoses

A minority of trial participants discontinued treatment due to gastrointestinal events, underscoring the importance of appropriate dose titration and proactive symptom management

Vitamin B12 is an essential nutrient required for many bodily functions

This suggests a lack of pronounced subgroup heterogeneity in the treatment effect within this study sample (Details in Supplementary Table 28 in Supplementary Material 2)

Beneficial bacteria produce short-chain fatty acids (SCFAs) like butyrate, acetate, and propionate when they ferment dietary fiber