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Long-term PPI use carries risks including hypomagnesaemia, vitamin B12 deficiency, and increased fracture risk particularly relevant in bariatric patients already prone to nutritional deficiencies

Taken together, the current evidence supports a mechanism-based model in which Bifidobacteria contributes to RE protection primarily through barrier reinforcement and anti-inflammatory immune recalibration, thereby breaking the feedforward loop of permeability, microbial translocation, and mucosal inflammation 61

The most significant challenge is the complete absence of pharmacokinetic data

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Hexarelin vs Ipamorelin Hexarelin and Ipamorelin represent opposite ends of the GHRP spectrum: maximum potency versus maximum selectivity