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The exact mechanisms of IIM pathogenesis remain unknown, but it is widely believed to result from the interplay of genetic, environmental, immune, and non-immune factors (endoplasmic reticulum stress, oxidative stress, abnormal autophagy regulation, hypoxia, and angiogenesis) [221]

Other data generated are available from the corresponding author upon reasonable request

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Hormone therapy is often integrated into broader functional medicine strategies that include IV nutrients, lifestyle changes, and botanical support

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