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Type 2 Renal Tubular Acidosis Type 2 RTA results from the inability of proximal tubular cells to reabsorb HCO 3 resulting in urinary excess (wasting) and consequent metabolic acidosis

This step-up approach helps reduce the likelihood of side effects while improving effectiveness

For Hashimoto's specifically, the question is whether improving insulin sensitivity, reducing visceral fat, and lowering inflammatory markers could slow the autoimmune destruction of thyroid tissue

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Standard fasting rules need not necessarily hold