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Clinical oversight is needed to monitor how these mechanisms interact

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Each of these conditions can cause significant systemic and ocular effects, and its critical to know which one is at play when caring for these patients

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More recent studies have reported alterations in monoamine metabolism in the cerebrospinal fluid and plasma of individuals with ME/CFS, particularly elevated levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), suggesting increased central serotonergic turnover (Yamamoto et al., 2004