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However, there are two apparent limitations of this review
doi: 10.1016/j.biopha.2019.109249
The clumped cells will sediment more rapidly leading to a raised erythrocyte sedimentation rate (ESR)

Meikle WG, Weiss M, Adjaye D, Ricigliano VA (2024) Comparative assessment of food consumption, longevity, thermoregulation, and molecular health markers in mite-resistant and Italian honey bee stocks

Therefore, always emphasize consulting a healthcare provider before starting or stopping any management, diet, or supplement protocol
