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This low-grade systemic inflammation: Impairs insulin receptor signalling, directly worsening insulin resistance Damages ovarian granulosa cells, impairing egg development and ovarian function Disrupts gut barrier integrity, contributing to what some researchers call a "leaky gut" pattern associated with systemic inflammation Amplifies HPA axis dysregulation, raising cortisol and further disrupting sex hormone balance Chronic inflammation is both a consequence of PMOS and a driver that perpetuates it

Prior investigations have shown that dietary Spirulina or its extracts stimulate an increase in intestinal IgA levels [21, 102, 103]

Amifostine Amifostine is another antioxidant drug shown in laboratory studies to neutralize several types of free radicals (Taylor 1997

Gastric electrical stimulation Gastric electrical stimulation (GES) uses a small, battery-powered device to send mild electrical pulses to the nerves and muscles in the lower stomach

MEOS uses a different enzyme (Cytochrome P450 2E1 - CYP2E1) to metabolize ethanol, but still creates toxic acetaldehyde

A comprehensive assessment of these variables is crucial for understanding the precise impact of diet on treatment efficacy