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after first month, then every 3 months) to track biomarkers

Recent studies demonstrate that gut microbiota modulate dietary tryptophan metabolism, producing bioactive metabolites such as indole derivatives, kynurenines, and serotonin that influence neurophysiology, mood, cognition, and the gutbrain axis (Yuxuan et al., 2026

To address this, future interventions should prioritize integrated synbiotic therapies, combining carefully selected probiotics with specific prebiotics to enhance microbial engraftment, stabilize gut ecology, and reinforce host metabolic and immune homeostasis (Balthazar et al., 2022)

However, approximately 70% of hepatic blood supply comes from the intestine via the portal vein, allowing fungi or their metabolites to translocate across the gut barrier and potentially exacerbate liver disease 10,12

Sinclair, A.O., Ph.D