Your goal dictates everything
Landmesser U, Cai H, Dikalov S, McCann L, Hwang J, Jo H, Holland SM, Harrison DG
Nausea: a review of pathophysiology and therapeutics
Ive seen this happen in two general scenarios: Scenario 1 : A patient is on chronic valproic acid, he/she may have mildly elevated ammonia levels from time to time and then these levels are noted to be increased from the patients baseline
Spironolactone is commonly used in this setting because it targets androgen-driven changes rather than directly targeting estrogen levels
If not kept in check, too much copper can lead to gastrointestinal issues and potential organ damage