10.1016/j.jprot.2009.10.005 114 MulemaJ
Fiber-rich diets add to these advantages by supplying fermentable substrates that boost SCFA generation, increase regulatory T-cell differentiation, modify microglial maturation, and improve BBB function
Contact your GP or oncology team if you notice: Sudden or rapid hair loss , particularly if occurring in patches (which may suggest alopecia areata, an autoimmune condition unrelated to tamoxifen) Scalp inflammation such as redness, pain, tenderness, or scaling which may indicate a scarring or inflammatory condition requiring specialist assessment Signs of androgen excess , such as new facial or body hair growth or acne, which warrant investigation Hair loss accompanied by other new symptoms , such as fatigue, unexplained weight changes, cold intolerance, or skin changes these may indicate an underlying thyroid disorder or other systemic condition Significant psychological distress related to changes in appearance, which warrants referral for appropriate support Hair loss that is persistent or worsening more than six months after completing chemotherapy, which warrants clinical review It is equally important that patients do not stop taking tamoxifen without consulting their oncology team
Commenters stated a delay until CY 2026 would allow CMS more time to refine the policy so it does not create inadvertent burden for all clinicians involved in the billing of these modifiers and would allow for time to adjust to new workflows
