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Response: CMS appreciates the commenter's perspective

Cycle length typically runs 8 to 12 weeks, followed by a 4 to 6 week rest period, with cycles repeated 2 to 3 times per year

Medical conditions: Certain health conditions, such as diabetes, thyroid disorders, nerve compression (radiculopathy), spinal stenosis, and liver disease (e.g., cirrhosis), can increase the risk

Exercise-responsive microbial metabolites, most notably short-chain fatty acids and tryptophan-derived compounds, have well-documented roles in regulating muscle energy utilization, insulin sensitivity, and mitochondrial function 18,75,76,77,78

However, this medicine is available for use only under a special program administered by the U.S