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GLP-1 RAs, acting via MC4R -independent pathways in the brainstem and hypothalamus [62,63] , may address this persistent hyperphagic drive that surgery alone cannot overcome
In a controlled study of solar urticaria patients given a single 16 mg afamelanotide implant, mean melanin density increased by day 7, peaked around day 15, and remained elevated at day 60 (Haylett et al., 2011)
& Chattipakorn, N
What a targeted study would look like A randomized human clinical trial comparing placebo to CLA alone, L-carnitine alone, and the combination over six to 12 months with body composition by DXA, fasting metabolic markers, kidney function and TMAO measurement would be ideal
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