Further analysis indicated that among the 19 overgrown bacterial families, 12 possessed the urease gene ( Alteromonadaceae , Clostridiaceae , Cellulomonadaceae , Enterobacteriaceae , Dermabacteraceae , Halomonadaceae , Micrococcaceae , Moraxellaceae , Methylococcaceae , Pseudomonadaceae , Polyangiaceae , and Xanthomonadaceae ), 5 harbored the uricase gene ( Dermabacteraceae , Cellulomonadaceae , Xanthomonadaceae , Micrococcaceae , and Polyangiaceae ) producing ammonia that is harmful to the intestinal epithelium, and 3 expressed the tryptophanase gene necessary for the conversion of tryptophan into indole, which is then metabolized by the liver into uremic toxins ( Enterobacteriaceae , Clostridiaceae , and Verrucomicrobiaceae ) (Wong et al., 2014)

4,14 Management strategies Reducing histamine intake involves eliminating aged cheeses, cured meats, fresh, canned, or fermented oily fish, fermented vegetables, citrus, strawberries, tomatoes, avocados, chocolate, nuts, wine, and beer from the diet
Synthetic peptides Synthetic peptides are lab-derived, created by deliberately linking amino acids in sequences that mimic endogenous peptides
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Clinical trials highlight a remarkable weight reduction average of 20.9% for those on the highest dose
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