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The primary risk is therapeutic failurepatients may experience rising blood glucose levels, inadequate appetite suppression, or weight regain if using compromised medication
Transgenic mice overexpressing des-acyl ghrelin show small phenotype
Similarly, although hepatic dysfunction can occur with large niacin doses (1-3 grams daily over months) causing elevated liver enzymes or jaundice, niacinamide at 100 mg is very unlikely to have any adverse effect on the liver
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