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Relative metabolic inflexibility can develop as a result, with increased reliance on glucose as an energy source and decreased capability of switching to alternative sources such as ketones (95, 96)

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Secondary bile acids, modified by microbial bile salt hydrolases (BSH), function as signaling molecules through receptors such as FXR and TGR5, influencing microbial composition by selectively suppressing pathogens and promoting symbionts like Bacteroides 40,46

207.2 95.1, 97 V/21 eV, S-methyl-ET