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Interactions with Medications and Substances Alcohol and Caffeine: Regular consumption of alcohol may interfere with the body's ability to absorb vitamin B12, potentially diminishing the efficacy of the injection and leading to suboptimal relief from deficiency symptoms

Moreover, in accordance with what has been discussed above, the lactate secreted by MSCs can not only induce M2 macrophage polarization, but promote the capability of DCs polarizing CD4 + T cells into Th2 cells, implicating the dynamic interaction between M2 macrophages and DCs [104]

But the most striking finding was the effect on relapse frequency

This corresponds with other studies that suggest a decreased HRV is present in ME/CFS, indicative of a chronically high sympathetic tone (78, 330, 332344)