Hepatotoxicity: acute hepatocellular toxicity, rarely fulminant hepatitis. It may present with elevation of liver function tests (ALT, AST, total serum bilirubin)
Mechanism: possibly formation of a reactive metabolite that causes loss of respiration and oxidative phosphorylation in mitochondria
Risk factor for toxicity: high dose
Any unused supplement should be retrieved to allow for a chemical analysis if needed.
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