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Additionally, if gut permeability is indeed increased in ME/CFS patients, microbes and antigens may be able to cross the epithelial barrier into surrounding tissue and blood, potentially crossing the BBB and altering the HPA axis (443)

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The studies provide encouraging signals to continue research using more rigorous methodology and standards

doi:10.1016/j.rbmo.2017.11.007

The selective action remains advantageous for lean individuals because it targets fat specifically without promoting water retention or tissue growth that might obscure definition