2f, ESM Fig
The concept of the circadian rhythmicity in the human secretion of renin and aldosterone, under the influence of posture, sodium intake and age, is well known from decades ( Hyperglycemia and RAAS in the Kidney High glucose levels in the proximal tubule can cause increased reabsorption of glucose, sodium and water, favored by the upregulation of SGLT2 activity and expression of Na-K-2Cl cotransporter, acquaporin-2, and urea transporters, as reported in diabetic patients ( Accumulated evidence has shown that the RAAS is no longer considered to act just as an endocrine system, but also as a paracrine, autocrine and intracrine system
The second is the evidence on the individual ingredients themselves
Between June and July 2025, when the formulary change was implemented, switching from AOM tirzepatide increased, while patients with an active supply of AOM semaglutide showed stable or even slightly reduced switching during the same period, consistent with its designation as the preferred option
I think that's because they get an MRI, the symptoms are similar, and there is some degenerative disease there because everyone in this population has connective tissue problems and they have less disc space these patients do have some progressive spinal disease
Results become much more obvious with continued use