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It was first identified as a factor by the greater prevalence of migraine in menstruating women and the association of some types of migraine with period-related changes in hormone levels

In this context, ammonia-lowering agents target impaired nitrogen metabolism, nutritional optimization and branched-chain amino acid (BCAA) supplementation address sarcopenia and metabolic imbalance, and microbiome-directed therapies aim to correct dysbiosis, which contributes to CHE pathogenesis

, 290 , 17576-17586, doi: Hofbauer, S

These factors may lead to synovial hyperplasia, pannus formation, bone erosion, and eventually irreversible deformities [1, 2]

The peptide is fragile and aggressive agitation can damage its structure