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In the bacterial community, core microbiota such as Firmicutes and Bacteroidetes are reduced, while Proteobacteria, including Escherichia-Shigella and Enterococcus, are significantly enriched [93, 94, 96]

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the more significant of these being the pH and the concentration of metal ions in the local microenvironment

doi: 10.1016/j.cell.2009.08.017

210 In a randomized, double-blind, placebo-controlled trial that included 81 healthy subjects, those who received 400 mg ebselen twice daily for four days, beginning two days before testing, exhibited 68% less of a temporary decrease in hearing 15 minutes after an experimental loud sound exposure compared with placebo

This combination works through complementary pathways that enhance nitric oxide (NO) production, bioavailability, and stability -- delivering benefits that exceed simple addition of their individual effects