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In sum, it is worthy to note that lipid peroxidation (LPO) products such as 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) arise as secondary messengers of oxidative stress, which is often counterbalanced by the cellular antioxidant defense system [133]

Unlike oral supplements, which your digestive system filters

Cisplatin is able to bind directly to the sulfhydryl groups of antioxidant enzymes in the cochlea, leading to the inactivation of the enzymes, and it also decreases the levels of glutathione and NADPH (Nicotinamide Adenine Dinucleotide Phosphate), both of which are essential for the activity of the enzyme glutathione peroxidase ( Reactive oxygen species (ROS) and their derived superoxide radicals can trigger cytotoxic effects through multiple mechanisms: first, excessive generation of ROS induces lipid peroxidation and leads to depletion of intracellular antioxidant enzyme levels, exacerbating the disruption of redox homeostasis

Its pathogenesis involves multifactorial mechanisms and exhibits significant variability in disease progression among individuals

That last rep represents more than muscular exhaustion