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This is further compounded by significant inter-individual variability, or the responder phenomenon, where the hosts unique gut microbiota composition determines whether a bioactive is metabolized into its active form

The use of amphetamine-like stimulants for MS fatigue remains controversial given their potential for cardiovascular complications as well as abuse and addiction potential

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The oxidative stress is the result of the imbalance of the antioxidant system in favor of prooxidants, which interferes with the GSH/GSSG system in the antioxidant defense and the regulation of gene expression, the synthesis of DNA and proteins, cell proliferation and apoptosis, and cytokine production and protein glutathionylation, due to alteration of certain cellular functions