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Patch is not waterproof
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McGill, C

Specifically, in women who are postmenopausal, exogenous estrogen causes homocysteine levels to drop, but prior to menopause, excess estrogen may increase homocysteine.[ref][ref] Both high and low homocysteine levels increase all-cause mortality, with the caveat that the increase in mortality risk is only seen if homocysteine is not low due to vitamin intake

This is consistent with the observed angiogenesis acceleration in tendon healing models
