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Certain bacteria produce histamine as a metabolic by-product through the action of L-histidine decarboxylase the same enzyme that converts the amino acid histidine into histamine

However, we have seen a sufficient number of patients with both thyroiditis and tumor to know that one diagnosis in no way excludes the other

If mild gastrointestinal discomfort occurs, dividing the total daily dose into smaller morning and afternoon portions can significantly improve tolerability while maintaining steady plasma levels

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