Regarding the causal relationship between BCAAs and IR, two main hypotheses currently exist: sustained high BCAA levels interfere with insulin signaling through mTOR complex 1 (mTORC1) activation leading to insulin receptor substrate-1 (IRS-1) serine phosphorylation
[DOI] [PMC free article] [PubMed] [Google Scholar] 165.Borlaug BA, Zile MR, Kramer CM, et al
Indirect in vivo evidence of oxidative involvement in metal induced pathotoxicity was demonstrated by alleviation of oxidative stress in the erythrocytes after treatment with thiol containing proven antioxidants, N -acetylcysteine and a succimer in arsenic exposed rats [115]
Since they are not FDA-approved, they do not have standardized FDA-required labeling, including side-effect warnings, boxed warnings, or risk evaluation and mitigation strategies that apply to approved drugs
Healthcare payers (such as the NHS) and prescribing physicians should consider these findings when evaluating GLP-1 receptor agonists as potential treatment options
But update the diagnosis once the cause is confirmed.