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It is an endogenous neuropeptide found naturally in airway nerve terminals and mast cells, with potent anti-inflammatory and bronchodilatory properties
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Consequently, pyridoxine significantly influences the adrenergic, serotonergic, and glutamatergic systems ( Pyridoxine may also exert a protective effect on the nervous system by regulating the glutamatergic system and thus modulating GABA and glutamate levels (60)
Patients describe a profound, unrelenting exhaustion that does not improve with rest and is dramatically worsened by physical or cognitive exertion, a pattern called post-exertional malaise (PEM)
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