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Adrenal insufficiency: Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use

have confirmed that the increase of circulating TMAO downregulates IL-10 and promotes vascular inflammation, contributing to endothelial dysfunction by mouse experiments (55)

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Oral glutathione loses 80-90% potency during stomach acid breakdown before absorption occurs

Downstream signaling through IRAK and TRAF6 via the MyD88 adaptor protein activates the IKK/NFB pathway, promoting the release of pro-inflammatory cytokines such as TNF, IL1, and IL6 and increasing reactive oxygen species (ROS), thereby generating a localized inflammatory storm. [81] In vivo studies have shown that MPs exposure upregulates TLR4, MyD88, and phosphorylated NFB, while inhibitors of TLR2/4 markedly reduce inflammatory damage, highlighting the importance of this pathway in MPs-induced immune toxicity [82]