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This chronic, systemic depletion allows environmental toxins and latent, dormant infections (such as EBV or human herpesviruses) to reactivate and accumulate, continuously driving immune dysfunction, mast cell activation syndrome (MCAS), and unrelenting fatigue

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In addition, IGF-I regulates the expression of key steroidogenic enzymes during prenatal development, which in turn lead to establishment of the male phenotype and fertility[129]

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