Chronic inflammation in PCOS is characterized by elevated levels of pro-inflammatory factors (including TNF-, IL-6, and CRP), which reduce the synthesis of type I collagen while enhancing the activity of matrix metalloproteinases (MMPs) (74, 75)
Standard prenatal vitamins containing 2.5-10 micrograms may be insufficient for those with dietary deficiency, so dedicated B12 supplementation is recommended
The exception: in March 2024, the FDA approved a supplemental indication for semaglutide 2.4 mg (Wegovy) to reduce the risk of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke in adults with established cardiovascular disease and either obesity or overweight (SELECT trial, Lincoff et al., New England Journal of Medicine 2023)
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This amplification of opioid analgesia goes along with the suggested role of the dopamine system failure, and the tonically active anti-opioid system (24-27)
It activates both GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptors