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Around 30% of patients start with bulbar symptoms, which affect the muscles used for speaking and swallowing, leading to problems like slurred speech (dysarthria), trouble swallowing (dysphagia), and twitching of the tongue muscles ( The disease usually begins in one part of the body and spreads gradually, leading to increasing muscle weakness

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Better Tolerance: Effervescent forms tend to be gentler on the stomach and suitable for vegetarians and those avoiding gluten

Furthermore, low levels of glutathione can exacerbate oxidative stress and insulin resistance

This suggests that other factors, including, potentially, Fc-dependent antibody effector functions and T cell activation, are also important in vaccine-mediated protection, especially when neutralizing antibody titres are low

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