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These changes shift the SB niche from resorption toward sclerosis, with neurovascular invasion into cartilage and inflammatory infiltration that further destabilize cartilage phenotype and metabolic balance (Su et al., 2020)

Altered testosterone levels (both too low or too high) have been implicated in causing structural damage to the heart, and increasing the risk for cardiac arrhythmias, heart attacks, congestive heart failure, and sudden death