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Nutritional deficiencies may also play a role, particularly in patients experiencing significant gastrointestinal side effects
This includes a complete metabolic panel, fasting insulin, HbA1c, fasting glucose, lipid panel (complete with LDL particle count if available), IGF-1, growth hormone levels (random and stimulated if possible), liver enzymes (ALT, AST, GGT), kidney function markers (creatinine, BUN, eGFR), complete blood count, and thyroid panel
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Oxidative stress, along with structural changes such as axonal loss and demyelination from toxic insults like hyperglycemia and alcohol consumption, are also associated factors
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