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The drug stops working as effectively around the 3-month mark due to tolerance

However, such a benefit might not be seen with DPP-4 inhibitors, since these drugs primarily potentiate levels of GLP-1 in the gastrointestinal tract and have modest effects on GLP-1 receptors in the systemic circulation [4]

For cognitive goals, acetyl-L-carnitine crosses into the brain more readily and is often preferred

Murugan M, Boison D (2020) Ketogenic diet, neuroprotection, and antiepileptogenesis