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This directly impacts the NAD+/NADH ratio, a fundamental determinant of cellular energy status and metabolic flexibility

Wipe the stopper with an alcohol swab before every draw

It was really, really low

GLP-1RAs enhance insulin sensitivity and lower fasting insulin levels

peripheral nerve motor or sensory loss, Guillaine Barre type syndrome, multiple cranial nerve palsies Immune related adverse events (IrAE) occur in up to 90% patients administered ipilimumab up to 70% patients administered PD1/PDL1 inhibitors (pembrolizumab, nivolumab, atezolizumab) First line pembrolizumab (PD1) in lung cancer 1 in 10 had a G3 or G4 toxicity (better than chemotherapy) 1 in 20 stopped treatment due to toxicity These are very rarely immunosuppressive drugs sick patients are unlikely to have neutropenic sepsis mainstay of treatment of immune related adverse events - STEROIDS Immune Related Adverse Events: Primary care need to be aware that side effects may not be immediate: onset of these toxicities varies but usually starts within the first 8 to 12 weeks of initiation of treatment Reference: Brooks M, Olsson-Brown A