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When combined with metformin, the results can be even stronger, leading to better glucose control, lower androgen levels, and improved menstrual regularity

Both medications begin working within the first few weeks, though maximum effects develop over 3 to 6 months as you reach your target dose

Reducing gas-producing foods during the adjustment period helps significantly

Abbreviations AIM2: Absent in Melanoma 2 ACP: Acid phosphatase AD: Atopic dermatitis AKP: Alkaline phosphatase ALT: Alanine Aminotransferase Increase AST: Aspartate Aminotransferase Increase AQP mRNA: Aquaporin mRNA ATF4: Activating Transcription Factor 4 Arf1: ADP-Ribosylation Factor 1 ALA: Alpha-Linolenic Acid ARA: Arachidonic Acid AMP: Adenosine Monophosphate ACP: Acid Phosphatase AKP: Alkaline Phosphatase AAs: Amino Acids Acetyl-CoA: Acetyl Coenzyme A AhRs: Aryl hydrocarbon receptors AMP: Antimicrobial peptide AhR: Aromatic hydrocarbon receptor BAs: Bile Acids B/F: Bacteroidetes/Firmicutes COL1A1: Collagen Type I Alpha 1 Chain C3: Complement Component 3 C4: Complement Component 4 CCR9B: C-C Motif Chemokine Receptor 9b (zebrafish homolog) CAT: Catalase COXIV: Cytochrome C Oxidase Subunit IV CDH2: Cadherin-2 CXCL11: C-X-C Motif Chemokine Ligand 11 CLEC10A: C-Type Lectin Receptor 10 A CHIT: Chitinase CLEC17A: C-Type Lectin Domain Family 17 COL: Collagen COL1A2: Collagen Type I Alpha 2 Chain CD80: Cluster of Differentiation 80 Caspase-3: Cysteine-aspartic acid protease 3 CLEC10A: C-Type Lectin Domain Family 10 Member A CMP: Cytidine Monophosphate CDH2: Cadherin-2 (N-Cadherin) CDCA: Chenodeoxycholic acid DAO: Diamine oxidase D-Lac: D-lactic acid DHA: Docosahexaenoic Acid ERK1: Extracellular Signal-Regulated Kinase 1 ECM: Extracellular matrix FTH: Ferritin Heavy FKBP1: FK506 Binding Protein 1 FXR: Farnesoid X receptor GMP: Guanosine Monophosphate GTP: Guanosine Triphosphate GALT: Gut-associated lymphoid tissue GPCRs: G-protein-coupled receptors GSDMD: Gasdermin D GC: Granulocyte GST: Glutathione S-Transferase GPCR: G-Protein-Coupled Receptor HO-1: Heme Oxygenase-1 HDL: High-Density Lipoprotein HYOU1: Hypoxia Up-Regulated 1 Hc: Hemolysin HDAC: Histone Deacetylase IgA: Immunoglobulin A IFN-: Interferon-gamma IL-6: Interleukin-6 IKK: IB Kinase Beta IBD: Inflammatory bowel disease I3A: Indole-3-aldehyde IPyr: Indole pyruvate IPA: Indole-3-propionic acid I3A: Indole-3-aldehyde Klf4: Krppel-Like Factor 4 Keap1: Kelch-Like ECH-Associated Protein 1 LAMA: Laminin Subunit Alpha LPS: Lipopolysaccharide LYZ: Lysozyme LCA: Lithocholic acid MALT: Mucosa-associated lymphoid tissue MAIT: Mucosal-associated invariant T MAC: Membrane attack complex Mep1: Metalloproteinase 1 Beta MyD88: Myeloid Differentiation Primary Response 88 MPO: Myeloperoxidase MCFD2: Multiple Coagulation Factor Deficiency Protein 2 MDA: Malondialdehyde Muc2: Mucin 2 MMP9: Matrix Metalloproteinase 9 NRF1: Nuclear Respiratory Factor 1 Nrf2: Nuclear Factor Erythroid 2 NLRP3: NOD-, LRR- and pyrin domain-containing protein 3 Nrf2: Nuclear factor erythroid 2-related factor 2 NF-BP65: Nuclear Factor kappa-light-chain-enhancer of activated B cells (p65 subunit) OCLN: Occludin PPO2: Prophenoloxidase PIGR: Polymeric Immunoglobulin Receptor PVEC: Pulmonary Vascular Endothelial Cells PVEC: Portal Vein Endothelial Cell PPAR: Peroxisome proliferator-activated receptor PDCD6IP: Programmed Cell Death 6 Interacting Protein PRRs: Pattern recognition receptors ROS: Reactive Oxygen Species RTN1: Reticulon 1 Retnlb: Resistin-Like Beta SCFAs: Short-chain fatty acids SOD: Superoxide dismutase SGC: Semi-granulocyte Serum TBA: Serum Total Bile Acids Increase SPP1: Secreted Phosphoprotein 1 S