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Sitagliptin and vildagliptin are not licensed for use in renal impairment, whereas saxagliptin can be used at a reduced dose and linagliptin can be used at the only strength available

And importantly in our situation, it significantly suppresses muscle protein breakdown through multiple complex metabolic routes

All PlexusDx compounded medications come from licensed 503A compounding pharmacies and are HSA/FSA eligible, requiring no insurance or membership fees

However, theyre not completely risk-free

One supplement that has gained traction in recent years is L-carnitine, touted for its role in energy production and fat metabolism

The date for manufacturers to notify CMS of their interest in participating was January 8, 2026