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While not strictly required, Vitamin C acts as a major catalyst for both

The mechanism involves the interaction of the bile acid metabolite GDCA with the intestinal inherent (innate) group 3 lymphocytes GATA binding protein 3(GATA3), resulting in reduced secretion of the anti-inflammatory regulator IL-22.The therapeutic potential of IL-22 has been demonstrated and its administration shown to ameliorates IR, ovarian dysfunction, and infertility in PCOS (173)

In the guidance, the administration noted oversight concerns and stated there was no compelling case that federal DSHP funding is a prudent federal investment. At the time, authority for DSHP in active / current demonstrations was not affected but they could not be extended or renewed