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Disrupted peripheral neurogenic signaling pathways between the liver and the brain axis, coupled with perturbed central neurotransmission within the brain, in tandem with disease-related or disease-associated factors, such as complications, treatments, and severity, as well as alcohol use, metabolic syndrome, and malignancy, collectively contribute toward clinical fatigue ( 2.3 Diagnosis and management Peripheral fatigue can be quantified through objective assessments of strength and aerobic capacity, while central fatigue is evaluated using self-reports and validated questionnaires that capture the patients perception of physical and mental exertion impacts on their activities and exertion levels

Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE

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A person on metformin with numb feet may be told it is diabetic neuropathy when it is actually a treatable vitamin deficiency the drug caused

Ptpn6 inhibits caspase-8- and Ripk3/Mlkl-dependent inflammation