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For example, in sensory neurons and nerve damage, higher BH4 levels lead to more pain.[ref] Genetic variants associated with higher BH4 production are associated with increased pain in chronic pain conditions.[ref] Similarly, people with genetic variants that cause lower BH4 production are significantly less likely to have pain, such as chronic pain or neuropathy.[ref] (See your GCH1 variants in the genotype report section below.) In addition, new research shows that BH4 may be involved in regulating miRNA that activates microglia in neuropathic pain.[ref][ref] 2