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Many herbal compounds exert effects on canonical molecular pathways relevant to this syndrome, including nuclear factor kappa B (NF-B), mitogen-activated protein kinase (MAPK), transforming growth factor-beta signaling (SMAD-dependent), and the nuclear factor erythroid 2related factor 2 (Nrf2) antioxidant response element (ARE) axis

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However, supplements provide a convenient alternative for those needing extra support

Clinician insight: systemic drivers such as environmental toxicants, diet quality, circadian disruption, and microbiome imbalance remain unassessed