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Clinical studies report moderate evidence in treating tendon injuries (tennis elbow, patellar tendinopathy), with measurable improvement over 6 to 12 weeks

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Its proposed mechanisms involve multiple cytoprotective pathways including upregulation of VEGF and growth factors promoting angiogenesis, modulation of the nitric oxide system, activation of the FAK-paxillin pathway for cell migration and tissue repair, interaction with the gut-brain axis affecting dopaminergic and serotonergic systems, and gastroprotective effects against NSAID and alcohol-induced mucosal damage

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