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Monitoring Requirements Combining these therapies requires careful lab monitoring, including: Total and free testosterone levels Estradiol (to ensure proper aromatase balance) Complete blood count (TRT can increase hematocrit) Metabolic panel (fasting glucose, HbA1c, lipids) PSA (prostate-specific antigen) Liver and kidney function Thyroid function Labs should be checked at baseline, at 6-8 weeks after initiation, and then every 3-6 months during ongoing treatment

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Opiate receptor antagonists such as naloxone or naltrexone cause ACTH release by blocking tonic inhibition by endogenous opioid peptides (100)

Figure 3 2.2.2 Vagotomy and insights into the microbiotagutbrain axis in Parkinson's The vagus nerve is the tenth cranial nerve