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International Journal of Molecular Sciences , 26(8), 3632.

The intestinal microbiome facilitates the synthesis of nitric oxide (Figure 2) 41 in the gut through the arginine citrulline pathway and in human endothelial cells from dietary flavanol derived gut metabolites

It is not approved for therapeutic use in humans, and no large-scale clinical trials have been conducted to evaluate its safety or efficacy as a medication