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This dysfunction manifests as reduced vascular response to dilators (particularly to NO and prostacyclin), heightened pro-inflammatory responses leading to vascular wall inflammation, increased oxidative stress contributing to vascular damage, and pathological changes

MTHFR shows tendency A genetic variant may affect risk or nutrient handling, but it does not establish the patients current methylation state

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Some researchers also include supportive supplements alongside peptide protocols: quercetin as a natural mast cell stabilizer, vitamin D for immune regulation, and omega-3 fatty acids for anti-inflammatory support