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(69) demonstrated that 14-day exposure to a eucaloric very-low-carbohydrate ketogenic diet as adjuvant treatment to first-generation somatostatin receptor ligands decreased IGF-I without increasing GH levels in acromegaly patients

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( 3 ) This can contribute to more regular cycles, improved metabolic health, and better management of associated symptoms

To support tolerance, GLP-1 treatment is started at a low dose and titrated upward, which helps reduce gastrointestinal side effects like nausea that can affect 20% to 40% of patients when treatment begins , as noted in the earlier payer-focused clinical guidance