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For instance, the breakdown of histidine in the gut produces imidazole propionate (IMP), which accumulates in the kidney

It is a strong anti-oxidant that is toxic to melanocytes hence by reducing these cells, it reduces melanin production

[24] in 2021, following clinical evaluation of the association between myocardial fructose and sorbitol levels and indicators of cardiac dysfunction in diabetic patients, reported that myocardial sorbitol and fructose levels were significantly elevated in patients with T2DM

References Alanazi MDS, et al

Ginkgo biloba prevents transient global ischemia-induced delayed hippocampal neuronal death through antioxidant and anti-inflammatory mechanism

PEM is also thought to be linked to insufficient ATP levels due to a lack of available adenosine, which delays the rapid replenishment of ATP stores post-exercise and may contribute to prolonged recovery times observed in these patients following physical exertion (Lengert and Drossel, 2015)