Different goals, different mechanisms
In the U.S., it is classified as a medical supply rather than a controlled drug
The BDNF increase from fasting appears to be related to the switch from glucose to ketone metabolism, as ketone bodies like beta-hydroxybutyrate directly stimulate BDNF gene expression in the hippocampus
Most GLP-1 medications can be used in chronic kidney disease, but exenatide products should be avoided when eGFR is below 30 mL/min/1.73m
This leads to the use of kojic acid and arbutin as alternative agents, but these agents show poor efficacy in vivo
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