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Sierra AY, Gratacs E, Carrasco P, et al

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However, patients with polycystic ovary syndrome (PCOS), insulin resistance, or other metabolic conditions should inform their healthcare provider before adding any supplement, since dose adjustments to either agent may become necessary as insulin sensitivity improves

Concomitant monitoring requirements (SUA levels and liver/renal function) impose additional burdens: frequent phlebotomy provokes patient resistance, while toxicity surveillance (ALT, AST, and creatinine) demands individualized schedules that increase healthcare encounters (Kaur et al., 2024

doi: 10.1016/j.anireprosci.2022.107095 42 LeahyTGadellaBM

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