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TNF secreted from adipose tissue can induce hepatocyte apoptosis and exacerbate inflammation through activation of the NF-B and JNK pathways, among other pathways [217, 218]
Furthermore, because AST is a carotenoid with lipophilic properties, there is concern about its potential to accumulate in tissues with prolonged use
Low protein intake on GLP-1 medications causes muscle loss, which worsens fatigue
The real mechanism (lowering the stress hormone cortisol that impairs the prefrontal cortex and hippocampus, plus a GABA-mimetic and mild acetylcholinesterase action)
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