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They can bind G-protein-coupled estrogen receptor 1 (GPR30), with effects driven by both genomic and non-genomic regulation involving different cellular signalling pathways, such as intracellular increase of calcium or NO levels (Reference Ropero, Alonso-Magdalena and Ripoll75) , as observed in human endothelial cells after stimulation with equol 100 nM (Reference Rowlands, Chapple and Siow76)

This variability explains why some people report visible skin changes while others experience primarily internal benefits like improved energy or immune function

This effect is mediated through the ER pathway, as indicated by the absence of LCN2 upregulation when an ER antagonist is present [73]

To ensure safe and effective use, patients should receive clear guidance on proper injection technique and handling