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However, Epithalon's promise comes with important caveats - most research conducted in Russia with limited Western validation, no FDA approval or large-scale international trials, long-term human safety data spanning years not decades, optimal dosing still based on Russian protocols rather than rigorous dose-finding studies, and mechanisms incompletely understood despite 40 years of research

Stupnisek, M

doi: 10.1038/s41591-022-01702-9

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It can be triggered by various causes, including viral hepatitis, autoimmune liver disease, and drug-induced liver injury