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Initial serological testing includes tissue transglutaminase IgA antibodies (tTG-IgA) with total IgA levels to exclude IgA deficiency

*Correspondence: Agata Blazewicz, [email protected] Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers

However, indirect mechanismsincluding weight loss, improved insulin sensitivity, and metabolic changesmay influence reproductive hormones and menstrual patterns in some individuals