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Consider the typical metabolic patient profile presenting to a clinic like Meto: Waking at 24 AM with an inability to return to sleep (a cortisol signature) Carrying visceral abdominal fat despite dietary effort Elevated fasting glucose or rising HbA1c despite reasonable lifestyle habits Fatigue despite adequate total sleep hours Poor recovery from exercise Blunted GH response (often confirmed on labs as low IGF-1) Each of these findings is consistent with slow-wave sleep deprivation and HPA axis dysregulation
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Moreover, we did not check for baseline folate and B12 status of our patients and cannot exclude imbalances between the groups in the pre-treatment status, which may happen is small size studies like the present one
