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Interestingly, the gut metabolic module aspartate degradation I, which converts L-aspartate to oxaloacetate by aspartate aminotransferase, was elevated in SAD patients and the authors hypothesized that bacterial aspartate aminotransferase enzyme activity may represent a link between gut microbiome function and the tryptophan-kynurenine pathway, a key physiological system in psychiatric disorders (Butler et al., 2023)

In the mITT population, the average change in the number of SSEs from baseline to the end of the study was +0.7 events per month in the pooled groups receiving 1.25 and 1.75 mg doses of BMT, compared to only +0.2 events in the placebo group

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Your provider may recommend dietary changes, anti-nausea medication, or a temporary pause before resuming at a lower dose