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These cases often involve an interplay between neuroautoimmunity and immune hypersensitivity, with mast cells amplifying the inflammatory response to microbial triggers

We recommend a gap of one to two weeks between sessions

However, levels of these mast cell mediators may be normal unless youre currently experiencing an episode

Some patients experience anxiety as a less common but documented side effect, likely related to appetite suppression affecting energy intake and blood sugar patterns
