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During perimenopause, when the gut microbiome is already shifting as oestrogen declines (affecting the estrobolome, the collection of gut bacteria that help metabolise oestrogen), alcohol adds further instability

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Moreover, acetate is more efficient in inhibiting ROS, and butyrate can reduce oxidative stress by increasing the concentration of reduced glutathione (Li et al., 2021)

Tirzepatide is taken in a once-weekly injection

Again, it's not up to me