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A predicted outcome of TGR inhibition in worms is the accumulation of oxidized GSH (GSSG) because of attenuated reduction to GSH by TGR, leading to decreases in the GSH/GSSG ratio

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This explains why some patients experience: Temporary bloating or joint discomfort from fluid shifts Increased hunger due to ghrelin pathway activation Changes in blood sugar regulation in susceptible individuals Patients with diabetes, insulin resistance, or other metabolic conditions require medical evaluation and appropriate monitoring before and during treatment