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Further, while low tryptophan dietary intake is rare, CFS and autoimmune hypothyroidism may be associated with an increment in indeloamine-dioxygenase (IDO) expression, which would promote the tryptophan-kynurenine pathway that decreases serotonin synthesis

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Elevated TMAO in the blood can contribute to insulin resistance by interfering with hepatic gluconeogenesis and glucose transport

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