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Some chelators, such as D-penicillamine, also cause direct neurotoxicity, likely by crossing the blood-brain barrier and disrupting copper-dependent central nervous system enzymes, impairing energy metabolism, and increasing oxidative stress [245, 246]

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This creates a complex clinical picture where short-term discomfort may lead to long-term benefit, requiring careful patient counselling and symptom management during the initial treatment phase

Semaglutide is an FDA-approved medication originally developed for managing blood sugar levels in people with type 2 diabetes