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This pattern reflects the underlying biology rather than treatment failure

10.1016/j.tem.2009.04.001 155 PugliaC.SantonocitoD

Extraintestinal ADs have been linked to gut barrier dysfunction, with increased mucosal permeability displayed by individuals suffering from inflammatory rheumatic diseases such as rheumatoid arthritis (RA) (Mielants et al

Authors' Contributions Liu JR, Deng ZH, Zhu XJ, Zeng YR, Guan XX, and Li JH contributed to this paper

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Given the emerging understanding of the gut-testicular axis and how gut-derived endotoxins may suppress testosterone (Tremellen, 2016), this property is potentially relevant to hormone health