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This dysbiosis is driven by multiple factors, including intestinal urea accumulation, impaired ammonia metabolism secondary to renal dysfunction, dietary modifications, and medical interventions ( Figure 2 ) [35, 111]

[50] Tseng CH

Trust the date, not the look: a clear solution can still have lost measurable activity, so the reconstitution date matters more than appearance

This distinction matters enormously for long-term use, where indiscriminate inflammation suppression can compromise immune function and healing capacity