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Challenges: Regulatory complexities across regions, peptide stability and bioavailability, and the need for rigorous quality control

For prolonged or repeated courses, clinicians sometimes check carnitine status and may consider supplementation under medical supervision

PD symptoms significantly improved, including motor function assessed by the Movement Disorder Society-Unified Parkinsons Disease Rating Score (MDS-UPDRS) Part III motor scores and cognitive function assessed by the Mattis Dementia Rating Scale-2 (Mattis DRS-2)

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At the time, the scientific consensus was that obesity was an issue of individual willpower, not a disease to be medicinally treated