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Prolonged activation of the cAMP/PKA pathway by ACTH induces an aberrant serotonergic stimulatory loop in the adrenal cortex that likely participates in the pathogenesis of corticosteroid hypersecretion

Only one study in patients with gastro-esophageal reflux disease (GERD) took the effort of comparing CLE to classical Ussing chamber experiments, which showed no differentiation between GERD and controls by probe-based CLE and no correlation of CLE findings and ex vivo permeability (51)

For users on maintenance doses who have stabilized their protocol, this concentration minimizes injection volume while maximizing vial longevity

Timing is flexible

Lab tests that can help include serum copper, ceruloplasmin, and zinc:copper ratios