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The Tier 1 supplements are: Whey protein isolate (to support protein intake at therapeutic levels) Complete multivitamin (broad-spectrum coverage of the vitamins and minerals most commonly depleted) Vitamin D3 plus K2 (near-universal deficiency in this patient group) Vitamin C (wound healing and collagen synthesis) Zinc (wound healing and immune function) These five supplements go into the Tier 1 group because the evidence base supports near-universal deficiency or increased requirement in post-weight-loss patients

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It is not difficult to diagnose PBC when the patients have typical features, particularly AMA positivity