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What usually helps: Slower titration and patience with dose increases Smaller meals and avoiding very fatty meals during escalation Prioritising protein and fibre, which can reduce empty stomach nausea Hydration, particularly if diarrhoea occurs The review explicitly discusses the impact of side effects on persistence and highlights the need for mitigation strategies

Defects in the AR gene can prevent the normal development of both internal and external male structures in 46, XY individuals and result in androgen insensitivity syndrome, which is the partial or complete inability of cells to respond to androgens 13,101,102

proposed in 1963 that the interaction between carbohydrate and fatty acid metabolism takes the form of a glucose-fatty-acid cycle that controls blood glucose levels, fatty acid concentrations and insulin sensitivity [97,98]

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