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Earlier studies reported associations between PN carnitine supplementation and improved physical development outcomes in preterm infants (43, 44)
BHB has been shown to reduce muscle protein breakdown and may even promote muscle protein synthesis, thereby exerting an anticatabolic effect [136, 137]
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However, potential adverse mental health effects have also been reported and require vigilance: Nausea and gastrointestinal symptoms , common side effects of GLP-1 medications, may increase anxiety in susceptible individuals Rapid weight loss can occasionally trigger psychological distress or exacerbate eating disorder behaviours Mood changes , including low mood, have been reported in post-marketing surveillance, though causality remains uncertain Some patients report feeling emotionally flat or detached , though this is anecdotal and not well characterised in clinical trials The Summary of Product Characteristics (SmPC) for GLP-1 receptor agonists used for weight management (such as Saxenda and Wegovy) includes specific warnings about monitoring for mood disorders and suicidal thoughts
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