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At later stages of the disease, several mechanisms have been proposed where the circulating ammonia can increase glutamine, which could secondarily impact energy metabolism through an initial osmotic stress, while changes in the glutamateglutamine cycle will follow

However, we recommend supplementing with citrulline to increase arginine, as arginine supplements dont produce significant increases in blood arginine concentrations due to the liver's effectiveness at clearing absorbed arginine

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The Use of Colchicine in Periodontal Diseases