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At the peripheral level, however, it could be detrimental because elevated peripheral blood 5-HT levels could be involved in increasing insulin and 5-HT release by pancreatic -cells via the 5-HT3 receptor and inhibition of glucagon secretion by -cells, resulting in exacerbation of hyperinsulinemia and hypoglycemia [282, 283]

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The estriol will exert its effects only locally to the area of skin applied

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