Extrapolating an approved HIV-lipodystrophy indication to those uses is exactly the kind of tier-inflation this reference is written to prevent
Constipation may also predispose bacteria to reach excessive populations, particularly Lactobacillus species that can execute tyrosine decarboxylation, L-DOPA by converting it into dopamine in the gut hence limiting its release into the bloodstream and causing motor fluctuations (Menozzi and Schapira, 2024)

Four trials were rated to have a low risk of bias (Reference Alperet, Rebello and Khoo24,Reference Hochkogler, Schweiger and Rust29,Reference Ohnaka, Ikeda and Maki38,Reference Wedick, Brennan and Sun44) , five trials were rated to have some concerns (Reference Bak and Grobbee25,Reference Bhn, Croft and Burrows27,Reference Kobayashi, Kawano and Ukawa31,Reference Lecoultre, Carrel and Egli32,Reference Mortazavi, Paknahad and Hasanzadeh34) and the other twelve trials were rated to have a high risk of bias (Reference Ahmed Al-Naggar, Osman and Abdulghani23,Reference Basu, Betts and Mulugeta26,Reference Cardoso, Salgado and Cesar28,Reference Kajimoto, Kajimoto and Yabune30,Reference Martnez-Lpez, Sarri and Mateos33,Reference Mousavi, Vafa and Neyestani35Reference Nabi, Sedighinejad and Haghighi37,Reference Revuelta-Iniesta and Al-Dujaili39,Reference Superko, Bortz and Williams40,Reference van Dusseldorp, Katan and van Vliet42,Reference Vieira Senger, Schwanke and Gomes43) (online Supplementary Table 3)

( + + )