This is dangerous territory in the fitness world
As with seropositive AIH especially in the scenario of non-response to standard immunosuppression, it is crucial to exclude other potential causes, such as viral hepatitis, genetic/metabolic disorders like Wilson disease, multidrug resistance protein-3 (MDR3) deficiency, etc., and drug-induced liver injury
Zhang W, Li P, Cai ZK, Zheng JH, Dai JC, Wang YX, et al
24 weeks[1] Elderly patients: May respond better due to age-related carnitine deficiency[2] Patients with mitochondrial dysfunction: Strong mechanistic rationale for benefit[9] Early intervention: Better outcomes when started before severe nerve damage Cost-Effectiveness Strategies: Purchase larger quantities (90-180 count bottles) for volume discounts Generic products with third-party verification offer best value Consider powder formulations for significant cost savings Start at lower dose (1,500 mg/day) and increase only if needed Combine with other nutraceuticals to potentially reduce pharmaceutical costs Maximizing Bioavailability: Divide doses throughout the day (saturable absorption)[3] Consider initial IM loading in severe cases (500 mg BID 14 days) followed by oral maintenance[10] Take with food to improve tolerability without significantly affecting absorption Ensure adequate hydration CLINICAL DECISION-MAKING 1
