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Hormonal alterations Since stress has been described as a potential trigger for ME/CFS (422) and cause of symptom flare-ups (423, 424), it is likely that the HPA axis- the neurobiological stress system- may be implicated in ME/CFS (53, 425, 426), as well as abnormalities in growth hormone (GH) secretion and dysfunctional adrenergic metabolism (255)

Cysteine is the rate-limiting constituent in the production of reduced glutathione, and it can be replaced by its precursor NAC

It is considered a mitochondrial-derived peptide (MDP) and functions as a metabolic regulator

Functional confirmation (cognitive testing, synaptic marker analysis) is often more practical than pharmacokinetic sampling for validating protocol effectiveness