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Overall, changes are commonly detected across the airways in response to e-cigarette vapor inhalation, with the broad pattern concerning for increased inflammatory responses

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Naturopathic strategies with the strongest evidence include targeted nutrient repletion (zinc in deficient individuals, methylcobalamin for B12, magnesium glycinate for neural stability), gut microbiome support via prebiotic fibre and probiotics, an anti-inflammatory dietary pattern, N-acetylcysteine (NAC) for cochlear oxidative stress, and structured mind-body approaches to reduce amplification of tinnitus perception through stress pathways

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