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However, a 2021 study by Sun et al

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( Nishida, et al 2018 ) Researchers in the Netherlands have stated "...in a state of inflammation, not only high levels of proinflammatory cytokines are produced but also altered levels of neurotransmitters, such as serotonin, a derivative of tryptophan metabolism, are detected in the gut." ( Waclawikov and Aidy 2018 ) So, we have another vicious cycle: disturbed microbiome inflammation low serotonin slow gut motility disturbed microbiome etc

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