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Metformin also downregulates TLR4-NF-B signaling in podocytes, decreasing pro-inflammatory cytokine production and MCP-1-driven macrophage infiltration (108)

Given the much greater potency of 7-OH as an MOR agonist, we hypothesized that even minor conversion to this product might contribute significantly to mitragynines analgesic activity and help to explain the apparent contradictions in the literature

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Using them together means you're not relying on one pathway when you could be addressing two simultaneously