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Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin

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Tumor-derived lactate suppresses cytotoxic T cell activity through multiple mechanisms: inhibiting T cell proliferation, reducing cytokine production, and promoting regulatory T cell (Treg) expansion

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"Modifiable risk factors for cancer"