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When Kisspeptin-10 binds to its receptor (KISS1R, also known as GPR54) on GnRH neurons in the hypothalamus, it triggers pulsatile release of gonadotropin-releasing hormone

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Why: Isotretinoin is derived from vitamin A and combining the two increases the risk of hypervitaminosis A , which can cause: Headaches / pseudotumour cerebri Liver toxicity Nausea Bone pain Skin peeling Mood changes Avoid: Vitamin A capsules Multivitamins containing high-dose retinol Cod liver oil (contains vitamin A) Most multivitamins have Vitamin A with very low levels ( 5,000 mcg

Typical Treatment Timeline During weeks one through two, most patients notice minimal external changes