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Co-administration of MB with any of these can lead to an acute surge in serotonin signaling in the central nervous system, manifesting as agitation, confusion, high fever, sweating, muscle rigidity or tremors, and potentially seizures or cardiovascular collapse

Over time, this results in reduced production of thyroid hormonesprimarily thyroxine (T4) and triiodothyronine (T3)which are essential for regulating metabolism, energy production, and numerous bodily functions