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Proper selection of strains and their combination for starter cultures is essential to develop fermented foods with increased folate content 1,123,302,434,469,518,519,813,814,815,816,817,818,819,820,821,822,823,824,825,826,827,828,829,830,831

Environmental stressors further modulated susceptibility: high ammonia levels damaged mucosal barriers and impaired tight junctions 107 , while thermal stress activated the hypothalamicpituitaryadrenal axis, inducing stress-related immunosuppression and weakening respiratory mucosal defense 108

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More serious but rare adverse effects include pancreatitis, gallbladder disease, and potential thyroid C-cell tumors (based on rodent studies