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The tryptophan-kynurenine pathway functions as a stress-activated metabolic system that diverts tryptophan from serotonin synthesis toward kynurenic acid production, which acts as a glutamate receptor antagonist and may contribute to anxiety pathophysiology through altered glutamatergic neurotransmission (Butler et al., 2022)

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Acting on insulin and glucagon levels, incretins, and thus TZP, may have indirect effects also on the liver and muscle

These will lead to various symptoms of irritation such as itch, erythema, edema and pain