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doi:10.1111/dom.14640 56

133 , e165654 (2023)

These gatekeeping strategies reduce insurer costs but delay patient access to medications shown in clinical trials to produce sustained weight loss of 1522% of body weight

3.1.1 Indoxyl sulfate (IS) Indoxyl sulfate (IS) is classified as a protein-bound uremic toxin, with its biosynthesis originating from tryptophan metabolism: gut microbiota first convert tryptophan into indole, which is then transported to the liver for oxidation and sulfation to form IS (Meyer and Hostetter, 2012)