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CHE is a multi-organ syndrome with complex interactions between the liver, gut, skeletal muscle, kidneys, and brain, with impaired ammonia handling and systemic inflammation acting as central drivers of this organ crosstalk
Semaglutide is the active ingredient in Wegovy and Ozempic , offering powerful efficacy and, unlike any other molecule in the GLP-1 class, it has FDA-approved medicines with a broad range of indications including: obesity (Wegovy ), type 2 diabetes (Ozempic ), type 2 diabetes and chronic kidney disease (Ozempic injection), and comorbid cardiovascular disease (Wegovy and Ozempic )
Patients without retinopathy should have dilated eye exams annually or every 1-2 years based on glycemic control
It is essential to start with a lower dose and gradually titrate up to assess tolerance, particularly for patients with severe ME/CFS who may be highly sensitive to metabolic shifts
Arc, arcuate hypothalamic nucleus
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