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Adherence matters because missed doses can reduce benefit and complicate assessment, so clear schedules and reminders are useful
Our TRT guide lays out who genuinely benefits from replacement and who is better served by fixing the metabolic picture first
And that has to do with the short chain fatty acids being good for the gut, and a lot of work done by a former colleague of mine and good friend, Mark Shigenaga, showing that the short chain citrate, malate, lactate, but specifically malate, really, and lactate are the major ones that get into the gut epithelial cells and are an energy source for the mitochondria and the goblet cells
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Beer and wine can also contribute because of the sulfites used during processing
And, though I am a big advocate for naturally reversing PCOS symptoms, including weight loss, Id not be doing my job as a PCOS dietitian if I didnt give you insight into other potential relief options
