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So I think folks might be getting hit too hard and getting driven too fast into that and theyre having what we call a Herxheimer reaction

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TNF- damages cardiomyocyte mitochondria by inhibiting glycolysis and reducing mitochondrial adenosine triphosphate (ATP) production through promoting oxidative and nitrosative stress, which can result in compromised cardiac systolic function and unfavorable cardiac remodeling [83, 84]

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