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Further exploration of the mechanism of BA in DKD metabolism found that Firmicutes, Bacteroidetes, Lactobacillus, Bifidobacterium and Clostridium can convert intestinal BA into secondary bile acids and affect lipid metabolism through enterohepatic circulation (EHC) (69)

Compounded medications are considered only when a practitioner determines that an FDA-approved medication is not appropriate for a patients specific medical needs and that a customized formulation may be appropriate

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