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Endothelial dysfunction has been demonstrated in vivo (306, 311), in the large vessels of ME/CFS patients (307, 311) through flow-mediated dilation (FMD) and in the microcirculation through post-occlusive reactive hyperaemia

From the perspective of clinical practice and dietary recommendation, our findings do not support a beneficial association of l-carnitine with CVD and its risk factors, but suggest potential harm

However, the broad-spectrum use of antibiotics has disrupted this balance, weakening the microbiotas natural protective functions and impairing the immune response, leading to gut dysbiosisan environment conducive to antibiotic-resistant strains (Patangia et al., 2022)

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