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These microbial products reach the liver and activate hepatic immune cells, particularly Kupffer cells, via Toll-like receptor 4 (TLR4) signaling, triggering the release of pro-inflammatory cytokines such as TNF-, IL-1, and IL-6 (222)
Common effects like nausea, diarrhea, and fatigue are typically manageable and may lessen over time, but some side effectssuch as thyroid issues or pancreatitisare rarer and more serious
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It can also be significantly impacted by social, economic, and environmental challenges that individuals may face like limited health education, financial constraints, and lack of social support
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