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Patients with mild to moderate renal impairment generally do not require dose adjustment, but closer monitoring may be warranted, particularly for signs of gastrointestinal adverse effects that could lead to dehydration and worsening renal function

I feel great

The mix of an initial high dose and weekly shots for a month is a strong way to manage the deficiency

There may also be a connection to sex hormones because most lupus patients are women of reproductive age with high levels of estrogen and low levels of progesterone, a hormone that supports pregnancy (x)

A 4-week minimum hold at each dose cuts GI adverse event rates by roughly half

Clapham, D