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Reactions have included anaphylaxis [see Warning and Precautions (5.1)] High levels of FSH indicating primary gonadal failure The presence of uncontrolled non-gonadal endocrinopathies (for example, thyroid, adrenal, or pituitary disorders) Sex hormone dependent tumors of the reproductive tract and accessory organs Tumors of pituitary gland or hypothalamus GONAL-f is also contraindicated in women who exhibit: Abnormal uterine bleeding of undetermined origin Ovarian cyst or enlargement of undetermined origin 5 WARNINGS AND PRECAUTIONS 5.1 Hypersensitivity Reactions and Anaphylaxis In the post-marketing experience, serious systemic hypersensitivity reactions, including anaphylaxis, have been reported with use of GONAL-f and GONAL-f RFF

This indicates large doses (20- 30 billion) do not provide additional benefit beyond moderate doses containing several billion bacteria

The Pathology of "Lyme Neuro-Psychiatry" Patients with Lyme have a 28% higher rate of mental disorders and increased suicidality [23]

doi: 10.1111/j.1365-2265.2004.02031.x 25

Current diagnostic methods, such as computed tomography angiography, magnetic resonance angiography, and ultrasonography, are often costly and inaccessible in many healthcare settings

19 However, due to the sequence conservation of orthosteric sites, in most cases, subtype selectivity remains an intractable issue, which implies the inevitable side effects of orthosteric drugs