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Most adverse events were mild to moderate precisely because the 4 week intervals allowed physiological adaptation
If the inflammation is coming from an autoimmune condition, active infection, untreated sleep apnea, heavy alcohol use, or another non-metabolic cause, the effect may be modest or incomplete
S Afr J Bot 129:388396 Chakraborty A, Devi RK, Rita S, Sharatchandra K, Singh TI (2004) Preliminary studies on antiinflammatory and analgesic activities of Spilanthes acmella in experimental animal models
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