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Additionally, if gut permeability is indeed increased in ME/CFS patients, microbes and antigens may be able to cross the epithelial barrier into surrounding tissue and blood, potentially crossing the BBB and altering the HPA axis (443)
Moreover, adverse effects of tirzepatide, such as gastrointestinal issues, could limit patient tolerance and broader adoption
NICE guidance on obesity and weight management recognises that sustained weight loss of 10% or more can significantly reduce the risk of type 2 diabetes, cardiovascular disease, and musculoskeletal problems
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