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Preclinical studies suggest ALA may help defend neurons against oxidative stress, support synaptic function, and maintain healthy levels of glutathione, a critical antioxidant in brain cells.12 25 Importantly, ALA can cross the blood-brain barrier, making it a promising candidate for addressing conditions where oxidative stress or mitochondrial dysfunction play a role

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30 In the PDA-TOLERATE trial, 26.0% of infants randomized to PDA pharmacotherapy, received paracetamol as first line treatment

These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance