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If fasting glucose rises above 110 mg/dL or HbA1c increases by more than 0.3%, the protocol should be paused and metabolic workup initiated

Finally, the possibility arises that meningococcus may use the olfactory and trigeminal nerves to reach the CNS directly from the nose, bypassing the bloodstream, but this intriguing hypothesis requires further support

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doi: 10.1016/j.jhepr.2019.07.002 188 SanyalAJ

So for now at least, the researchers are still advising that people with a personal or family history of MTC (or a closely related, inherited condition called MEN2) not take these drugs

However, some individuals may experience initial gastrointestinal side effects when starting berberine