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Reports also indicate that compounded products are being combined with B vitamins or levocarnitine, additives that are claimed to bolster the drugs impact on weight loss, but may introduce new interactions impacting safety or effectiveness (Blum, 2023)

Figure 2 3.1 Metabolic effect of KD and -HB In this context, KD can influence tumor cell growth by lowering insulin and insulin-like growth factor-1 (IGF-1) levels, thus reducing one of the most common oncogenic pathways such as PI3K-Akt-mTOR implicated in tumor cell proliferation and tumor growth (34, 35)

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