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Early use of n-acetylcysteine with nitrate therapy in patients undergoing primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction reduces myocardial infarct size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction])

A randomized controlled trial conducted by Dixon et al.57 showed that the dual administration of prebiotics and metformin produced favorable changes in the microbiota but did not reduce the gastrointestinal adverse effects

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10.1016/j.abb.2008.03.008 Arch

We may also check thyroid markers (TSH, Free T4) and Vitamin D depending on your symptoms

Referral for blood tests checking zinc, iron, B12 or other relevant levels when indicated