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Eur J Clin Invest 54(12):e14292 Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH et al (2023) 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the management of patients with chronic coronary disease

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This is why supplementation is often recommended

A probiotic treatment dramatically raised the amount of Lactobacillus and reversed immunological alterations while reducing anxiety and depressive-like behaviors (233)