In children, a significant decrease in insulin has been reported with only 6 months and 16 weeks of diet [51]
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Its pathophysiology involves multiple interconnected mechanisms, including monoaminergic neurotransmitter depletion, impaired neurotrophic signaling, neuroinflammation accompanied by hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and glutamate-induced excitotoxicity (Medeir et al., 2020)
Free Radic Biol Med 190:7593
This gradual titration reduces the chance and severity of digestive side effects, including diarrhea, because your gut has time to adapt