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For instance, oedematous SAM is associated with secondary immune deficiency, intestinal dysbiosis, epithelial barrier disruption, and growth faltering, all of which exacerbate inflammation and worsen immune dysfunction (appendix p

10.2147/IJN.S132163 31

Furthermore, the inhibition of proteolytic enzymes was suggested to promote the activation of apoptotic events in MCF-7 breast cancer cells (228)

Ethics declarations Competing interests J.M.R has been a paid consultant to Aquestive Pharmaceuticals, Danone Nutricia, Mallinckrodt, Eisai Pharma and Zogenix, and has served on the Scientific Advisory Board of The Charlie Foundation for Ketogenic Therapies (Santa Monica, CA, USA)

Visible skin changes wont appear yet, but internal processes are already starting