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Chronic sympathetic dominance (the "fight-or-flight" state) maintains cortisol elevation, which directly suppresses secretory IgA your gut's primary antibody defence against Candida

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For most patients, metformin plus tirzepatide is now preferred over metformin plus insulin, unless insulin is specifically needed (very high HbA1c, type 1 diabetes features, etc.)

You notice changes in blood sugar regulation

Both can influence appetite, weight, and metabolic parameters, necessitating individualised prescribing decisions and ongoing monitoring

Wright has also been diagnosed with cyclic vomiting syndrome, which causes her to throw up multiple times a day