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This poor absorption is driven by extensive first-pass metabolism in the liver and active clearance by P-glycoprotein efflux pumps in the intestines, which actively push the berberine back out into the gut lumen

if a dose is missed, take it as soon as possible within 5 days of the missed dose [4]

To address the second question, a systematic study of plasma GSH that includes high-risk cohorts and first-degree relatives will be useful

These studies were retained because the topic remains under debate in the literature and was considered to require a systematic review to identify the most appropriate approach, despite significant gaps in the current research

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