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With persistent hypoxia, HIF-1 remains activated and drives abnormal expression of downstream genes, including heme oxygenase-1 ( H O -1 ) (Zhai et al., 2023)

Consider Milk Thistle Milk thistle, known for its liver-supporting properties, contains silymarin, a compound that may enhance glutathione levels

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Therefore, parenteral cyanocobalamin should be administered to a pregnant woman if the benefits outweigh the risks (10, 11)