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But the reality involves a complex chain of immune events that begins long before any symptom appears
The entire process is regulated by NF-kB, a master transcription factor that controls the expression of hundreds of inflammatory genes
It is not a toxicity concern but an efficacy consideration
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Other indicators include a family history of pernicious anaemia or other autoimmune conditions (such as type 1 diabetes mellitus, Hashimotos thyroiditis, or Graves disease), or if the patient is taking metformin, proton pump inhibitors (PPIs), H2 antagonists or has a history of nitrous oxide misuse[15]
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