In one study, serum C4 levels (a marker of bile acid synthesis) decreased from 23.4 21.1 ng/mL at baseline to 4.9 8.2,8.7 12.1,13.8 12.9 and 18.8 16.8 ng/mL at 1,3,6 and 12 months after SG, suggesting a reduction in bile acid synthesis post-SG [75]
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It may also increase the risk of infection or side effects
Medication changes: Recent adjustments to dose or delivery mechanism, as well as what stage of titration (if applicable)
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That lack of attainability and affordability is also something Pearlman is seeing in her Florida practice
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