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The increase in biotin may be due to fluctuations in diet, seasonal changes, or the plant-based extract which was used in the placebo (not the supplement) to give it a "vitamin-like" flavor

In addition to the indirect consequences of long-term oral antibiotic consumption on intestinal barrier health, particularly through reducing the numbers of SCFA-producing species, these therapeutics have also been reported to directly impair the gut barrier by reducing the expression of TJ proteins and negatively impacting their morphology

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Likewise, this includes as well those seen in the long term (i.e., a counteracting of the ensuing systemic muscle disability [254] (i.e., paralysis) and consequent muscle damage (in the injected muscle and non-injected muscle, hyperkalemia [255] and arrhythmias [256]), with leg-contractures rapidly eliminated [81]

These additional problems need to be evaluated and treated when an HSD is diagnosed