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Methylfolate is required in the activation of tetrahydrobiopterin (i.e., BH4), which is a necessary cofactor for both tryptophan hydroxylase and tyrosine hydroxylase, enzymes required in the synthesis of serotonin and norepinephrine/dopamine, respectively (Figure 1)

In women with PCOS, hyperandrogenism, insulin resistance, and adipose-derived inflammatory cues have been associated with altered neutrophil activation profiles, including increased oxidative stress, degranulation, and markers suggestive of neutrophil extracellular trap (NET) formation

Therefore, these substances can occupy this CYP2D6, leaving it less available to convert tamoxifen into endoxifen

The effects of chicory inulin-type fructans supplementation on weight management outcomes: Systematic review, meta-analysis, and meta-regression of randomized controlled trials