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Mechanistically, high expression of BCAT1 reduces the NAD + /NADH ratio, increases mTORC1 activity, and promotes oxidative phosphorylation and nucleotide biosynthesis

The good thing however is most of them are not of a permanent kind

Clinical trials have demonstrated that slow dose escalation significantly reduces the incidence and severity of these gastrointestinal symptoms, which are the most common reasons for treatment discontinuation

Today, its one of the top three highest-grossing drugs on earth

You start at 2mg weekly and gradually work your way up to a maintenance dose of 8mg, 10mg, or 12mg depending on your response and tolerance