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The exact reason for this is not yet understood

Those who improve with injections rarely improve with oral or sublingual products no matter how large the dose because the routes of administration are not capable of achieving high enough absorption levels

Recent studies have demonstrated that BMSC-Exos can promote neurological recovery in ASCI by inhibiting ferroptosis through the Nrf2/GTP cyclohydrolase I (GCH1)/5,6,7,8-tetrahydrobiopterin (BH4) signaling axis, reducing oxidative stress, and enhancing the expression of ferroptosis suppressors [146]

GPX4 inhibition triggers ferroptosis by allowing unchecked lipid peroxidation