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Investigations are guided by clinical suspicion rather than routine panels: for example, thyroid function tests and ferritin may be checked if symptoms suggest deficiency or thyroid disease, while an androgen profile may be appropriate in women presenting with menstrual irregularity, hirsutism, or acne

Mol Aspects Med 64:109134 Lehner A, Staub K, Aldakak L, Eppenberger P, Ruhli F, Martin RD, Bender N (2021) Impact of omega-3 fatty acid DHA and EPA supplementation in pregnant or breast-feeding women on cognitive performance of children: systematic review and meta-analysis

This poses a dual risk: while ENMs are often employed for their antimicrobial properties, their indiscriminate or chronic use could inadvertently select for resistant strains, complicating both clinical and ecological health management ( Given the breadth of these interactions, the current review aims to provide a comprehensive overview of the current understanding of ENMmicrobiome dynamics, the effects of various NMs on the human gut microbiota, aquatic and soil microbial ecosystems, and the potential for ENMs to influence microbial resistance development