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We have decided to publish this experience in spite of its limited size, as we think the outcomes achieved with our multimodal therapy with combined antioxidants in these patients may prove useful in urology and andrology practice, and we would welcome randomized controlled studies being carried out in the future to investigate the effectiveness of this treatment in a larger number of PD patients

[20] Patients should contact their GP or bariatric team promptly if they experience any of the following: New or worsening tingling, numbness, or weakness in the limbs Difficulty with balance, coordination, or memory Unexplained fatigue, breathlessness, or palpitations A sore or swollen tongue, or persistent mouth ulcers Any concern that they have missed supplementation for a prolonged period Symptoms that suggest anaemia, such as pallor or dizziness New or worsening neurological symptoms such as paraesthesia, gait disturbance, or cognitive change warrant same-day assessment

10.1038/s41598-025-87182-6 28 LienW