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Manipulation under anesthesia (MUA), which may be recommended in more persistent cases to help release the tightened joint capsule

Key evidence: A pilot RCT by Kumar et al

The glucose fluxes through the glycolytic pathway and the TCA cycle, enable the production of NADH and ATP

Reported side effects Mild headache or fatigue typically transient during initial use Mild gastrointestinal discomfort reported in some oral formulation users Sleep disruption or irritability potential sign of overstimulation Theoretical safety concerns Critical note: Because Dihexa activates the HGF/c-Met pathway which promotes cellular growth and repair there is a theoretical concern that it could potentially stimulate unwanted cell proliferation in individuals with active cancer or high cancer risk