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The good news is that having no gallbladder does not automatically disqualify someone from using semaglutide, though medical supervision and careful monitoring become even more important

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3.5.2 Microbiome alterations and the gutbrain axis in CFS/ME Multiple studies have established that individuals with CFS/ME exhibit significant alterations in their gut microbiome composition compared to healthy controls

In addition, in the same paper, the authors showed that the expression of monocarboxylate transporter (MCT), such as MCT1 and MCT4, are increased by lactate, along with a boost in oxidative phosphorylation (OXPHOS) activity, supporting a quiescent state and a reduced proliferation