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Managing Side Effects When Combining Therapies GLP-1 medications sometimes cause nausea, constipation, or changes in appetite perception during the first few weekseffects that are independent of testosterone therapy

Ross, R., Neeland, I

That is the mechanism of action by which those epic is working

When bacteria ferment carbohydrates and proteins in your stomach, they produce hydrogen sulfide gasthe compound responsible for the characteristic rotten-egg smell

ETA Selective vs Dual ETA/ETB Blockade Feature ETA Selective (e.g., zibotentan, ambrisentan) Dual ETA/ETB (e.g., macitentan, bosentan) Pulmonary vasodilation Strong Strong Antifibrotic effect Preserved Preserved ET1 clearance via ETB Preserved Blocked Nitric oxide signaling Preserved Reduced Fluid retention risk Lower Higher HFpEF tolerability Better Worse PHLHD trial outcomes Neutral Negative / harmful Clinical Trial Signals (HighLevel) * Dual ERAs in PH due to left heart disease showed no benefit and more edema * ETA selective agents demonstrated: * Better hemodynamic tolerability * Less sodium and water retention * More favorable pulmonary vascular resistance effects without excessive PCWP rise No ERA has shown outcome benefit in HFpEF, but harm signals are stronger with dual blockade