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Bariatric surgery may be considered for eligible patients with severe obesity according to NICE obesity guidance and can lead to significant improvements in NASH and fibrosis

The recycling of citrulline back to l-Arg via ASS/ASL (the citrulline-NO cycle) pathway sustains NO production even under low plasma l-Arg availability [120]

Providers should explicitly document these conditions and link them to metabolic dysfunction

Patients may experience: Nausea and upset stomach (sometimes severe enough to cause vomiting) Constipation from slowed gastric processes To mitigate these unpleasant symptoms, I often tell my patients: Dont try to out-eat the medication