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Increased muscle mass may also enhance energy expenditure and redirect energy use toward muscle rather than fat storage.[22] In humans, elevated MSTN levels have been associated with obesity.[27] In mice, MSTN inhibition reduces white fat accumulation, improves lipid metabolism in diabetic models, and promotes browning of white fat.[28] As low muscle mass is a risk factor for insulin resistance and obesity,[29] increasing muscle via MSTN blockade may enhance insulin sensitivity, partly through irisin-driven crosstalk between muscle and fat.[30] Irisin is an exercise-induced adipomyokine, generated by cleavage of the transmembrane protein fibronectin type III domain-containing protein 5 predominantly in skeletal muscle and, to a lesser extent, in adipose tissue

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If in the office, patients may pay for their first month of treatment at that time