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Start with a low-dose probiotic and increase gradually

The intake captures the FDA black-box contraindications including personal and family history for medullary thyroid cancer and MEN-2 syndrome alongside a 22-item comorbidity multi-select that includes pancreatitis history, severe depression, sleep apnea, T1/T2 diabetes, retinopathy, warfarin use, fatty liver, congestive heart failure, and PCOS

& Ashkenazi, A

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Maski K, Trotti LM, Kotagal S, Robert Auger R, Swick TJ, Rowley JA, et al

Renal-Impaired Individuals: Chronic kidney disease is a major risk factor for diabetes, and many antidiabetic drugs are either contraindicated or need dose modifications in patients with renal impairment